Root Fracture Middle Third Splinting — ORE Part 1 MCQ

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ModeratePaediatric DentistryRoot Fracture Middle Third SplintingORE Part 1

A 9-year-old child presents with an upper permanent central incisor that has a horizontal root fracture in the middle third detected on periapical radiograph. The coronal fragment is slightly mobile but not displaced. The tooth is vital. What is the recommended splinting duration?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — 4 weeks with a flexible splint

Explanation lettering: D = shown as A · A = shown as B · E = shown as C · C = shown as D · B = shown as E

The International Association of Dental Traumatology (IADT) guidelines recommend a minimum of 4 weeks of passive, flexible splinting for root fractures in permanent teeth. For middle-third horizontal root fractures with vital coronal fragments and minimal displacement, this duration allows adequate stabilisation for periodontal ligament and bone healing whilst maintaining physiological mobility. Option A is correct: 4 weeks with flexible splinting follows evidence-based consensus. Option B (2 weeks) is too brief. Options C (1 week) and E (12 weeks) fall outside standard recommendations. Option D (8 weeks) exceeds the minimum guideline duration without additional indication in this case.

Reference: International Association of Dental Traumatology. Guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth (2012, updated 2020). Dent Traumatol. Endorsed across UK practice via SDCEP and dental school curricula. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112395/