Complicated crown fracture: a case report

Abstract

This case report describes the treatment of a severe crown fracture of an immature mandibular permanent incisor in a 12 year-old boy referred to the Dental Traumatology Center of UNIGRANRIO University. After conventional endodontic procedures and dressing with calcium hydroxide, an apical plug was made with mineral trioxide aggregate in order to avoid an overflow of gutta-percha and endodontic sealer into the periapical tissues. Two years later, the tooth was clinically asymtomatic and radiographs showed total repair of the apical lesion.

The Management of Crown Fracture of Immature Teeth by MTA and Calcium Hydroxide: Case Reports

“…For Case 1 after Ca(OH) 2 medication, a plug of 4 mm of MTA was introduced to the apical parts of the canal with a fitted gutta-percha cone under radiographic evaluation. MTA has been considered an excellent root-end filling material as it provides good sealing ability and is biocompatible to periapical tissues [12]. The apex closure finalized within one year, and two-year follow-up showed good periapical repair.…”

“…If the pulp vitality of a traumatized immature tooth is lost, the treatment will be a challenge, especially for pulp necrosis in teeth with inadequate radicular development due to the fact that an open apex in permanent tooth takes approximately 3 years to close after tooth eruption [2,9,[11][12][13]. In the case of pulp necrosis, pulpectomy and root canal therapy should be preferred [12]. If the apex is not completely formed, the standard treatment option for traumatized immature permanent teeth with necrotic pulp is apexification.…”

Fracture coronaire avec exposition pulpaire d’une incisive permanente maxillaire immature : à propos d’un cas

“…Le traitement doit tenir compte aussi bien du degré de l'immaturité de la dent que des exigences esthétiques. Dans le cas de traumatisme sévère qui compromet la vitalité pulpaire, le traitement endodontique, associé à des moyens de rétention secondaires, devient une nécessité [3,4]. L'apexification est la thérapeutique de choix pour le traitement des dents permanentes à apex ouvert [5,6].…”

Horizontal root fracture in the apical third: case report

“…Fidel et al 10 presented a case of tooth fracture in a young patient, treated with calcium hydroxide; medication change must occur during the apexification process. After endodontic therapy, the tooth was monitored for 12 years to demonstrate success.…”

“…Along with this clinical finding (Figure 3), there is obliteration of the apical canal. Monitoring this tooth must go on for a long time and Fidel et al 10 recommended that radiographs are repeated annually for 12 years.…”