Repair of a horizontal mid-root fracture accompanied by labial luxation and partial alveolar fracture: a 21-year follow up.

The prognosis of injured teeth involving horizontal mid-root fractures is poor and depends heavily on pulpal vitality, periodontal health and the repositioning of the tooth to its original position. Here, we report the case of an upper right central incisor presenting a horizontal mid-root fracture, complicated by impaction of the coronal fragment in the external alveolar bone, which in turn prevented the repositioning of the tooth fragment. As a consequence, it was necessary to raise a full-thickness flap and perform window-osteotomy to free the coronal fragment and reset the fractured fragment. Short-term follow up revealed pulpal vitality of the affected incisor and tissue repair at the level of the line of fracture, without any signs of periapical or periradicular pathology. In this paper, we describe some of the clinical features found upon revising this case 21 years later. The affected tissues are in good health, the root fracture is repaired and the pulp maintains its vitality.