Dental trauma: management of complicated crown root fractures

Dental Update ◽  
2019 ◽  
Vol 46 (11) ◽  
pp. 1050-1055
Author(s):  
Khawer Ayub ◽  
James Darcey
Keyword(s):  
Functional Result ◽  
Dental Trauma ◽  
Traumatic Injuries ◽  
Crown Root ◽  
Anterior Teeth ◽  
Dental Practitioners ◽  
Root Fractures ◽  
Maxillary Incisors ◽  
Made In

Trauma of maxillary incisors is frequent and dental practitioners have to be competent in managing the consequences. Complicated crown root fractures of anterior teeth can have profound aesthetic and psychological implications on patients. In younger patients, if extractions are considered, it can lead to complex prosthodontic challenges in the future. Ideally, an attempt should be made in restoring the traumatized teeth, so an effective aesthetic and functional result can be reached. This case report highlights the treatment of complicated crown root fractures on maxillary incisors using endodontics and fragment re-attachment of the fractured crowns. Twelve-month follow-up of the treatment demonstrated aesthetic and functional success and delayed the need for prosthetic replacement. CPD/Clinical Relevance: This paper describes traumatic injuries of teeth and how management via fragment re-attachment of the fractured crowns has led to delay of definitive prosthetic treatment.

Multidisciplinary Approach to Complicated Crown-root Fracture Treatment: A Case Report

2021 ◽  
Author(s):  
MD Alves ◽  
MA Tateyama ◽  
NNO Pavan ◽  
AF Queiroz ◽  
MCP Nunes ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Dental Trauma ◽  
Good Prognosis ◽  
Root Fracture ◽  
Crown Root ◽  
Root Fractures ◽  
Viable Approach ◽  
Biologic Width ◽  
Composite Restoration

SUMMARY Treatment of complicated crown-root fractures is one of the most challenging within the various types of dental trauma and requires a multidisciplinary approach. This paper reports the complicated crown-root fracture of a maxillary right central incisor, in which there was esthetic, functional, and biologic (endodontic and biologic width invasion) involvement. A 15-year-old male patient presented to the dental clinic one month after suffering trauma with a complicated crown-root fracture on tooth 8. The patient had previously undergone endodontic treatment and was sent to have periodontal surgery to reestablish the biological width on the palatal surface. Following the surgery, a fiberglass post was cemented, and the fragment was reattached. This approach allows the exposure of the cervical margin, adequate isolation, and subsequent fragment reattachment in the same clinical appointment. Fragment reattachment is a viable approach as it is a simple and conservative procedure that restores the natural esthetic of the tooth and has superior resistance compared to a composite restoration. The patient’s cooperation in understanding the limitations of the treatment and maintaining adequate oral hygiene are very important to achieving a good prognosis of the case. After a 2-year clinical and radiographic follow-up period, the clinical protocol was found to be successful, and the tooth remained functional, esthetically favorable and asymptomatic.

scholarly journals Esthetic Rehabilitation of a Fractured Permanent Maxillary Central Incisor by Reattachment

2016 ◽  
Vol 6 (1) ◽  
pp. 52-56
Keyword(s):  
Case Report ◽  
Surface Texture ◽  
Simple Procedure ◽  
Dental Trauma ◽  
Central Incisor ◽  
Fiber Post ◽  
Root Fracture ◽  
Maxillary Central Incisor ◽  
Crown Root ◽  
Anterior Teeth

ABSTRACT Crown fractures of the anterior teeth are a common form of dental trauma mainly affecting children and adolescents. One of the options for managing crown fractures is the reattachment of the fractured fragment when the tooth fragment is available with minimal or no violation of the biological width. Reattachment of fractured fragments can provide good esthetics, as it maintains the tooth's original anatomic form, color, and surface texture. It also restores function and is a relatively simple procedure. This case report deals with the esthetic management of a crown-root fracture that was successfully treated with endodontic treatment followed by reattachment of fractured fragment with fiber post. How to cite this article Shaikh SAH, Shenoy VU, Sumanthini MV, Pawar RB. Esthetic Rehabilitation of a Fractured Permanent Maxillary Central Incisor by Reattachment. J Contemp Dent 2016;6(1):52-56.

scholarly journals Different Treatment Modalities followed by Dental Practitioners for Ellis Class 2 Fracture – A Questionnaire-based Survey

2020 ◽  
Vol 14 (1) ◽  
pp. 59-65
Author(s):  
Jerry Jose ◽  
Ajitha P. ◽  
Haripriya Subbaiyan
Keyword(s):  
Traffic Accidents ◽  
Sports Injuries ◽  
Dental Trauma ◽  
Treatment Modalities ◽  
Practical Application ◽  
Traumatic Injuries ◽  
Adequate Knowledge ◽  
Dental Practitioners ◽  
Knowledge And Attitude

Introduction: Dental trauma is one of the most commonly seen injuries involving teeth and surrounding structures. The frequent causes of dental trauma are usually falls, traffic accidents, fights and sports injuries. Rapid treatment can prevent long-term damage to the orofacial structures and save the teeth. Ellis class 2 fracture is classified as the involvement of enamel and dentin excluding pulp. Dental practitioners are used to treating Ellis class 2 fracture very often in their dental practice and is usually considered as a dilemma among dental practitioners for the different treatment modalities followed for treatment of Ellis class 2 fracture. A survey is done among dental practitioners to assess the different treatment modalities followed by them in the case of Ellis class 2 fracture. Materials and Methods: A survey was done among 380 dental practitioners in the Chennai region in which 360 dental practitioners responded. The survey was distributed through electronic media and other means of communication. The survey data was collected, analysed and interpreted. Results: The results suggested that about 90% of dental practitioners had adequate knowledge and attitude towards the management of dental traumatic injuries. However, the practical application of the different treatment modalities was seen to be varied among dental practitioners. Based on this survey it was clear that majority of the dental practitioners in Chennai have good knowledge, attitude but there was a lack of clinical practice regarding the different treatment modalities followed by general practitioners for Ellis class 2 fracture. Conclusion: The survey shows that dental practitioners have a sound knowledge, attitude, but the practical application of the various treatment modalities available was seen to vary among various dental practitioners for Ellis class 2 fracture.

scholarly journals Prevalence and aetiology of dental trauma in 8-14 year old school-going children of Hyderabad city, India

2020 ◽  
Vol 6 (3) ◽  
pp. 32-38
Author(s):  
Tanzeem Ahmed ◽  
Nikhil Kaushal ◽  
Sujeet Singh ◽  
Rashmi Agarwal
Keyword(s):  
Social Sciences ◽  
Dental Trauma ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Traumatic Injuries ◽  
Anterior Teeth ◽  
Traumatic Dental Injuries ◽  
Dental Injuries ◽  
Type Of Fracture

Aims and Objectives: To determine the prevalence and etiology of fractured anterior teeth due to trauma among 8–14 years old school going children of Hyderabad city. Materials and method: A cross-sectional study was carried out in 8-14 year old children studying in various schools of Hyderabad for the assessment of traumatic injuries of anterior teeth. Clinical examination was carried out and type of teeth affected, type of fracture, overjet and lip competence were noted. A closed end questionnaire was given to children with questions regarding etiology of trauma, place of injury, symptoms or outcomes after the injury, whether a dentist was consulted, type of treatment done by dentist and time elapsed between trauma and treatment. All the results were analyzed using “statistical package for social sciences” (SPSS) 20.0 software. Results: The prevalence of dental trauma was found to be 7.84%. 11-14year old children showed higher prevalence. Males were more affected than females. Maxillary central incisors were most affected. Fracture involving enamel and dentin were recorded the highest. Children having overjet of >3mm and incompetent lips were at a higher risk of dental trauma (p value = 0.001). The most common cause of injury was sports and home was the most common place of occurrence of injury. Most of the traumatic dental injuries (TDI) did not undergo any treatment. Conclusion: Increasing the awareness of the parents and teachers about the prevention of TDI and the importance of consulting the dentist after trauma should be instituted.

scholarly journals Restoration of Primary Anterior Teeth with Glass Fiber-Reinforced Post and Core: 3-Year Follow-Up Case Report

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Salah Afraa ◽  
Hashim Raghad ◽  
Khalid Ayam ◽  
Hamid Aeshah
Keyword(s):  
Glass Fiber ◽  
Primary Teeth ◽  
Pediatric Dentistry ◽  
Endodontic Treatment ◽  
Fiber Reinforced ◽  
Anterior Teeth ◽  
Glass Fiber Reinforced ◽  
Post And Core ◽  
Maxillary Incisors

Background. Esthetic appearance of primary anterior teeth is one of the major demands in the dental field. Destructed anterior primary teeth due to caries is considered a major issue due to the difficulty in regaining the esthetic crowns and attaching them until the normal exfoliation time. There have been many attempts and tools used to attach the composite crowns to the treated canals of primary anterior teeth. The study evaluates endodontic treatment for destructed primary maxillary incisors with a glass fiber-reinforced post as a retentive tool to hold the esthetic composite crowns until the normal exfoliation time of primary incisors. Case Presentation. A four-year-old child attending a dental clinic complained of pain of maxillary incisors. Dental examination showed irreversible pulpitis of four maxillary incisors indicated for root canal treatment and crown placement. Endodontic treatment was carried out, and a glass fiber-reinforced post was used to get successful retention for the composite crowns. Follow-up was carried out for 3 years. The 3 crowns were retained successfully until replaced by permanent incisors. One crown fell during the treatment course. Conclusion. Retention of primary teeth is one of the challenges in pediatric dentistry. Restoration of primary decayed incisors is important for child medical, physical, and psychological conditions. A glass fiber-reinforced post and core is a strong retentive tool for composite crown retention for primary incisors. This procedure opens the door for a strong tool to retain composite crowns for a long time. The glass fiber-reinforced post and core is a strong retentive tool for composite crown retention for primary incisors.

scholarly journals Management of Sub-gingival Fracture of Tooth by Multi-disciplinary Approach

2019 ◽  
Vol 3 (3) ◽  
pp. 165
Author(s):  
Atiquzzaman Khan ◽  
Shirin Sultana Chowdhury ◽  
Rubaba Ahmed ◽  
Mirza Md Arifur Rahman ◽  
SMA Quader
Keyword(s):  
Root Canal ◽  
Multidisciplinary Treatment ◽  
Dental Trauma ◽  
Young Male ◽  
Health Sciences ◽  
Maxillary Incisor ◽  
Elastic Band ◽  
Crown Root ◽  
Root Fractures ◽  
Wire Hook

Dental trauma is commonly occur in children and may involve adult person also. In permanent dentition crown fracture is common and it may be uncomplicated or complicated. Complicated crown-root fractures require a multidisciplinary treatment modality for longterm success. Here we presented multidisciplinary treatment of a traumatized permanent maxillary incisor of a young male patient where oblique tooth fracture involved coronal pulp. As more than 50% of the crown and palatal coronal part of the root had been fractured and the tooth could not be properly isolated during endodontic procedure which is essential for success of root canal treatment. An intra-canal wire hook was cemented in the root canal and attached to another wire fixed to the adjacent teeth. With the help of elastic band attached with hook the fractured tooth fragment was extruded to create clinical crown. Finally, gingival re-contouring was performed to establish optimum biological width. At last, porcelain fused to metal crown was placed and the patient was comfortable both esthetically and functionally.International Journal of Human and Health Sciences Vol. 03 No. 03 July’19. Page: 165-168

scholarly journals Management of Horizontal and Multiple Crown-Root Fractures

2011 ◽  
Vol 2 (4) ◽  
pp. 338-341
Author(s):  
Ramya Raghu ◽  
DS Sahana
Keyword(s):  
Dental Health ◽  
Traumatic Injury ◽  
Mineral Trioxide Aggregate ◽  
Fracture Site ◽  
Root Fracture ◽  
Delayed Treatment ◽  
Crown Root ◽  
Root Fractures ◽  
One Year

ABSTRACT Traumatic injury to oral cavity with accompanying tooth fracture can be a tragic experience for the patient and is a problem that requires experience, judgment and skill of the dentist. The dental health and appearance marred by an unsightly injury must be restored to normal as soon as possible. Though, root fractures comprise 0.5 to 7% of injuries affecting the permanent dentition, improper and delayed treatment can lead to loss of tooth. This report records a clinical case of intraalveolar horizontal mid root fracture in maxillary right central incisor with subluxation of coronal segment, which was managed endodontically using mineral trioxide aggregate (MTA), as an apical barrier at the fracture site. Maxillary right lateral and left central incisors affected by oblique crown-root fracture which were restored by custom-cast post and crown. After one year follow-up, the teeth were asymptomatic and showed signs of healing apical to the MTA barrier.

scholarly journals MTA Cvek Pulpotomy Followed by Fragment Re-Attachment in Traumatized Young Permanent Maxillary Left Central Incisor – A Case Report

2021 ◽  
Vol 30 (1) ◽  
pp. 70-73
Author(s):  
Abul Khair Zalan ◽  
◽  
Khadeejah Khalil Zubairy ◽  
Hira Zaman ◽  
Anser Maxood ◽  
...  
Keyword(s):  
Case Report ◽  
Dental Trauma ◽  
Functional Results ◽  
Clinical Results ◽  
Central Incisor ◽  
Anterior Teeth ◽  
Alternative Approach ◽  
Long Term Follow Up ◽  
Dent Assoc

Most common form of dental trauma in children are the fractures of crown mainly in anterior teeth. A case of complicated crown fracture treated with Cvek pulpotomy using MTA followed by fragment re-attachment with careful follow-up is presented here. Tooth fragment re-attachment provides feasible conservative alternative approach to restore esthetics and tooth function. Successful outcomes have been shown by the long term follow up of the treatment with the preservation of pulp vitality and continued development of root. Clinical results have also shown good esthetics and functional results of presented technique. KEYWORDS: Complicated crown fracture, Cvek pulpotomy, MTA, fragment re-attachment HOW TO CITE: Zalan AK, Zubairy KK, Zaman H, Maxood A, Gul A, Anser M. MTA cvek pulpotomy followed by fragment re-attachment in traumatized young permanent maxillary left central incisor – A case report. J Pak Dent Assoc 2021;30(1):70-73.

Management of Traumatized Permanent Maxillary Immature Incisor with Oblique Subgingival Crownroot Fracture

2018 ◽  
Vol 14 (1) ◽  
pp. 58
Author(s):  
Dr. Muna S. Khalaf ◽  
Dr. Bayan S. Khalaf ◽  
Dr. Shorouq M. Abass
Keyword(s):  
Treatment Approach ◽  
Resin Cement ◽  
Permanent Teeth ◽  
Treatment Level ◽  
Fiber Post ◽  
Anterior Teeth ◽  
First Choice ◽  
Choice Of Treatment ◽  
Root Fractures

Background: Trauma to the anterior teeth is a common injury in young children. Themaxillary incisors being the most affected. Although root fractures are rare, theydo occur and were previously and often considered hopeless and were extracted.The time between the injury and the initiation of treatment, level of the fractureline, and stage of root development are some criteria to be considered whenchoosing a treatment approach for a complicated tooth fracture. This case reportdescribes the management of a traumatized immature maxillary central incisorwith Elise class IV fracture with vertical oblique subgingival fracture of the root.Materials and method: Apexification was carried out using biodentine followed byremoval of the fractured segment. A fiber post was cemented in the root canalwith resin cement. The coronal portion of the tooth was restored using anteriorlight cured composite material. The tooth was examined and evaluated after 1week and after 2 months by clinical examination and radiographical evaluation ofroot development.Results: The follow up evaluation revealed clinical and radiographical success.Radiographic view showed continued development in the apex of the root andshowed normal periodontal ligament space and dense lamina dura.Conclusion: Extraction should not be the first choice of treatment for extensivelydamaged young permanent teeth in the anterior region; instead, alternativetreatment modalities must be considered. The traumatized immature tooth wassaved and restored.

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