Root fractures in children and adolescents: diagnostic considerations

Purpose: To (1) characterize epidemiological trends in anterior permanent tooth trauma (2) examine the relationship of crown fractures and root fractures to determine if crown fractures are protective against root fractures (3) determine the diagnostic value of obtaining three periapical radiographic projections to assess potential root fractures. Methods: Two dentists served as expert examiners for the radiographic assessments. Kappa statistics, Pearson's Chi-Square tests and logistic regression analyses were employed. Results: The final sample included 185 teeth. Expert examiners detected: 22 root fractures, 10% of the teeth exhibited root fractures when no crown fractures was documented, and 14% of the teeth had both crown fractures and root fractures as separate entities. Conclusions: Crown fractures were not protective against root fractures. As radiographic projections increased, root fractures were identified more often. Our data support obtaining multiple radiographic projections at different vertical angulations to rule out root fractures in children and adolescents