Unusual horizontal root fracture in a 2nd molar during disim
The present case has been reported in the Annals of Maxillofacial Surgery.

A 16-year-old patient presented with pain in the right posterior region of the mandible and history of pericoronitis episodes. The initial radiography demonstrated that the third inferior molar with anterior angulation and the II-A Pell and Gregory classification. The treatment consisted of removing the dental element under a local anesthesia using lidocaine 2% with 1:100.000 epinephrine.

An incision in the retromolar region extending to the vestibular region of inferior second molar was performed. The blade was tilted toward the inferior and an “L” mucoperiosteal flap was performed to expose the tooth. After this, an ostectomy was performed in the vestibular region, followed by a dental section in the cementitious junction, a crown separation using a dental elevator, and the extraction of the 2 parts. No abnormal events were noticed during the surgical procedure.

An immediate postoperative X-ray showed a horizontal fracture of the mesial root of the lower right inferior second molar. The clinical evaluation presented with no mobility, and because of this, no immobilization was done. After 1 week, the sutures were removed, and the patient reported no discomfort around the lower second molar.

Clinical evaluations including pulp vitality tests and tooth mobility evaluation were performed weekly. Seven months later, another X-ray was taken that showed root healing with a small callus and without any trace of root fracture.

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