Traumatic injuries to teeth are a prevalent global health concern, with primary front teeth in young children being particularly susceptible. Early management is essential, as losing primary teeth prematurely can negatively impact both appearance and function. While extrusion, lateral luxation, and intrusion are the most frequently observed injuries, root fractures are relatively rare but may lead to extraction if not correctly identified and treated. Limited evidence exists regarding strategies for managing root fractures in primary teeth. This review examines the current understanding of their treatment and proposes a practical clinical approach based on existing findings. Searches were conducted in Web of Science, PubMed/MEDLINE, and SCOPUS, focusing on patient age, fracture location, type of displacement (intrusive, extrusive, lateral), emergency or diagnostic interventions performed, adherence to IADT guidelines, and follow-up periods. Only eight studies met the inclusion criteria, reporting on 46 patients with 62 root fractures. Among upper incisors, splinting was the most common management approach (n = 39), with durations ranging from three weeks to three months, averaging six weeks. No intervention was applied in 23 fractures. Most cases employed semi-rigid splints fixed with composite resin, while a single study used an orthodontic splint with brackets and 0.5 mm stainless steel wire. Although uncommon, root fractures in primary teeth may cause complications such as delayed or altered eruption of permanent teeth. Conservative treatment, including accurate radiographic assessment, immediate repositioning, and semi-rigid splinting, can help preserve the affected teeth and reduce the risk of premature loss in young children.
