Clinical management of a complicated crown-root fracture using autogenous tooth fragment: A biological restorative approach

Abstract

Trauma resulting in crown-root fracture is one of the most challenging fracture types. However, biologic width involvement should be carefully evaluated. Reattachment of tooth fragment to a fractured tooth remains as the treatment of choice because of its simplicity, natural esthetics, and conservation of tooth structure. The reattachment procedure using composite resin should be considered if the subgingival fracture can be exposed to provide isolation. This report presents a case of complicated crown-root fracture of permanent maxillay left central incisor, involving the biologic width in a 10-year-old girl. The traumatized tooth was treated endodontically. Access to the subgingival margins was gained by orthodontic extrusion followed by gingivectomy. The fractured fragment was reattached using bonding system and composite resin.

Multidisciplinary Treatment of Complicated Crown-Root Fractures: A Case Study

“…14-16 Orthodontic extrusion is favorable for maintaining periodontal health and preserves the crown-root ratio, but the procedure is time consuming, requiring five weeks to achieve 2-3 mm of extrusion and a retention period of about 8-10 weeks. 11,14,17 Surgical extrusion of the tooth is a less time consuming procedure, but there is a risk of root resorption and compromising the integrity of the periodontal ligament. 14 During the reattachment of separated fragments, they should be kept out of the mouth for as little time as possible so that they can remain moist and prevent dehydration; in this way, they maintain an adequate bond strength and their original esthetic appearance.…”

Cone-Beam Computed Tomography in Assessment of Reattachment of Chisel Fracture of Anterior Tooth in Young Patient- A Case Report

“…They can be complicated or uncomplicated fractures depending on the presence of pulpal involvement which involves the biologic width of the tooth. 12 The reattachment of coronal fragment is one of the best method to restore the fragment's natural tooth structure by maintaining occlusal alignment, shape of tooth, surface texture, colour and contour of the tooth. 13 It get rids the patient worry, with this approach which is comparatively simple, atraumatic and inexpensive with minimal wear of restorative materials and offers superior aesthetic & functional results in an appointment and maintaining the periodontal attachment.…”

Traumatismo dentoalveolares, características clínicas e imagenológicas: Una revisión de la literatura

“…Los niños son más afectados que las niñas y la edad de incidencia de trauma fluctúa entre los 6 y los 15 años. Por este motivo, es muy importante que reciban el tratamiento lo antes posible, a fin de prevenir y evitar complicaciones relacionadas con la erupción dental, el desarrollo alveolar, la oclusión y el crecimiento facial (1,5,10,13,16,17,(20)(21)(22)(23)(24)(25)(26)(27). Además del dolor y la incomodidad de la lesión, la alteración en la apariencia del niño puede convertirlo en objeto de burla por parte de otros niños, por las posibles deformidades que puede causar el traumatismo (27,28).…”

“…Las fracturas compuestas corono-radiculares involucran esmalte, dentina, pulpa y cemento. Radiográficamente, se observa que la línea de fractura se encuentra por debajo del límite subgingival, a nivel de la cresta del hueso alveolar interdental (20). El manejo de este tipo de traumatismos compuestos es un desafío, ya que la fractura requiere el reposicionamiento del margen de fractura supragingival para la ferulización sobre tejido sano y su posterior restauración (42) ( fig.…”