"A healthy mouth, makes a pleasant and functional
social message positive and reassuring."

dc. Maurizio Serafini

Clinical Cases

Oral Implantology

Radicular Fractures

Radicular fractures are damages on one or more roots, they can affect one small part or the whole root. They are often found in our studies.

The main causes of radicular fractures are:

weakening of the radicular walls due to excessive canal boring
weakening of the radicular walls due to pivot stump preparation
excessive occlusal loads
secondary decay rate
advanced chronic periodontitis


Symptoms can vary and depend on the severity of the damages from a slight discomfort to sporadic pains that cannot be relieved by undergoing root canal operations or receiving an antibiotic therapy, like in case of fissures (fig. c)

One should pay close attention to fissures whose symptoms (such as neuralgia) persist in time, even after targeted therapies. In this case the patient feels relief when the compromised tooth is pressed with a finger.
Image C

Other symptoms include: heaviness, pain, gingival redness or swelling, spontaneous pain which increases under the masticatory pressure, and even fever in case of pus formation due to bacterial infiltration, tooth mobility and complete fractures (fig. b).



CASE REPORT:

40-year old woman with a gumboil on 2.2:

Given the noticeable gingival recession of a few millimetres in apical direction, we decided to proceed with the extraction and insert an immediate load implant (fig. 4-5-6), using Platelet Rich Plasma (PRP).

Images 7 and 8 show blood samples that after centrifugation separate into two layers: an upper layer with PRP and a lower one consisting of a heavier corpuscular part.

Image 9 shows where the fixture - its stump - was placed and the dehiscence of the vestibular bone (5-6 mm).

Image 10 shows the Bio-Oss bone graft and PRP.

Post surgery check and sutures.

Image 13 shows the temporary elements placed.

After 8 months, notice the papillas

Definitive Zirconia-ceramic element Fig. (15-16-17-18)

Control X-ray after one year showing a successful osseointegration of the implant: