Use of CBCT cinematic rendering to evaluate the healing of an oblique root fracture with conservative management. A case report and literature review

Background: Dental trauma can cause root fractures involving the pulp and periodontal tissues. It is important to manage these injuries appropriately, as conservatively as possible, to promote healing of the affected hard and soft tissues while maintaing functionality and esthetics. Case: This report describes a case of conservative treatment of a palatally displaced oblique root fracture of an immature maxillary central incisor in a 7-year-old boy, using cinematic Cone Beam Computed Tomography (CBCT) rendering to monitor and provide accurate information about the healing process of the fracture line. The clinical examination revealed some degree of mobility and palatal displacement of the coronal fragment of the left maxillary incisor. Radiographic examination using X-ray films revealed a root fracture in the left maxillary central incisor and an incompletely formed root. The tooth showed a slightly positive response to the cold test. After tooth reduction, repositioning, and splinting of the tooth with orthodontic wire and composite for 6 weeks, the tooth was followed up for 24 months for vitality tests and periapical radiographs to monitor root development and/or any pathological root resorption. Finally, 37 months after the trauma, a CBCT was taken and the healing process of the root fracture and tooth maturation by cinematic CBCT rendering. Conclusions: This report underscores the importance of accurate diagnosis, decision-making, and conservative clinical management in the healing process following root fractures. Integration of new technologies, such as cinematic CBCT rendering, enhances the diagnostic accuracy and treatment planning of root fractures.

Cinematic rendering; Cone-beam computed tomography; Healing; Root fracture; Traumatic dental injury

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