Question

A patient recently received a blow to the mouth. Radiographs show a horizontal midroot fracture of a maxillary central incisor. The tooth is not mobile and is asymptomatic; however, it does not respond to pulp testing. No radiographic lesion is present. Proper treatment is to

A. institute root canal treatment to include both segments of the tooth.
B. extract the coronal segment of the tooth and remove surgically the apical segment.
C. remove surgically the apical segment of the tooth and retrofill the coronal segment.
D. perform root canal treatment and place an implant pin to hold the two segments together.
E. render no treatment at this time. The tooth should be periodically rechecked clinically and radiographically.

Answer 1

The appropriate management for an asymptomatic horizontal midroot fracture of a maxillary central incisor is to monitor the tooth without immediate intervention, periodically reassessing both clinically and via radiographs.

Step-by-step explanation:

The proper treatment for a patient with a horizontal midroot fracture of a maxillary central incisor that is not mobile, asymptomatic, and not responding to pulp testing without any radiographic lesion is to render no treatment at this time. The tooth should be periodically rechecked clinically and radiographically. This approach allows for the natural healing process to occur and avoids any unnecessary procedures that may compromise the tooth's integrity or cause further issues. In situations where a tooth's pulp cavity is compromised, such as in caries, a root canal treatment might be necessary, but this does not apply to this case since the tooth is asymptomatic and stable.