-Crown fractures account for the highest percentage of all traumatic injuries in the permanent dentition. This review paper will discuss the different types of crown fracture, from the uncomplicated to complicated, including crown-root fractures. It will focus on two different aspects: the pulp, with an attempt to correlate epidemiological, experimental, histopathological and clinical studies, so that the clinician can better understand the underlying processes accounting for success or failure to maintain pulp vitality. Also, we will consider the restoration: knowledge about bonding to dentin and new material is evolving extremely quickly making it difficult for the clinician to keep up with the developments. If handled properly, prognosis of the pulp, after traumatic crown fracture, is good. Prognosis of the restoration has also improved considerably over the last few years, and it appears that this trend will continue in the future.

Composite inlays are indicated for large cavities, which frequently extend cervically into dentin. The purpose of this study was to compare in vitro the marginal and internal adaptation of class II fine hybrid composite inlays (Herculite, Kerr) made with or without composite bases, having different physical properties. Freshly extracted human molars were used for this study. The base extended up to the cervical margins on both sides and was made from Revolution (Kerr), Tetric flow (Vivadent), Dyract (Detrey-Dentsply) or Prodigy (Kerr), respectively. Before, during and after mechanical loading (1 million cycles, with a force varying from 50 to 100 N), the proximal margins of the inlay were assessed by scanning electron microscopy. Experimental data were analysed using non-parametric tests. The final percentages of marginal tooth fracture varied from 30.7% (no base) to 37.6% (Dyract). In dentin, percentages of marginal opening varied from 9.2% (Tetric Flow) to 30.1% (Prodigy), however, without significant difference between base products. Mean values of opened internal interface with dentin varied from 11.06% (Tetric Flow) to 28.15% (Prodigy). The present results regarding dentin adaptation confirmed that the physical properties of a base can influence composite inlay adaptation and that the medium-rigid flowable composite Tetric Flow is a potential material to displace, in a coronal position, proximal margins underneath composite inlays

Amongst all dental traumas in the permanent dentition, crown fractures account for the largest majority. This review paper will discuss the different levels of fracture, from the most superficial ones only affecting the enamel to the deepest ones with pulp exposure, including crown–root fractures. It will focus on the pulp by evaluating the pulp response to trauma and to the subsequent treatment. An attempt to correlate epidemiological, experimental, histopathological, and clinical studies will be made, so that the clinician can better understand the underlying processes which evolve towards pulp healing or pulp necrosis, thus success or failure. If handled properly, prognosis of the pulp following a traumatic crown fracture is good. In the permanent dentition, success rate ranges between 72% and 100%, the highest success rate corresponding to superficial fractures and the lowest success rate to fractures with pulp exposure.