Yes, I do work on other teeth besides upper anteriors…We’ve just had a few neat recalls this week.

This a case of a horizontal root fracture. The endo was done 1.5 years after the accident because no vitality had returned to the tooth and a grey caste was developing. Endo for prevention of infection was advised. Teeth with horizontal root fractures are tough teeth to endodontically treat and once infection sets in, the prognosis becomes even more guarded.

Once I started the endo, I got through necrotic tissue coronally, but as I approached the fracture line, I found vital tissue (was able to tell because of hyperemia). In order to try to preserve as much of this tissue as possible (to help with potential reduction and stabilization of the fracture and also for possible biologic closure of the end of the coronal root fragment–ie. apexification) I minimally instrumented to the fracture and then filled the canal to that point with white MTA (mineral trioxide aggregate).

Two years later, osseous healing is complete and the root segments appear to be stabilized. Mobility has reduced. There’s a cosmetic issue now though. Although I used white MTA and the pt’s dentist bleached the tooth prior to placing the final resin, it’s turning more and more grey. Oh well, at least he still has the tooth.

And speaking of horizontal root fractures, here is a case that I did years ago. I wouldn’t necessarily do the same thing today but the post op film looks cool.