Conservative and Aesthetic Emergency Management in Adolescent with Complex Crown-Root Fracture and Simultaneous Oblique Root Fracture in Upper Maxillary Central Incisor: Clinical Outcome after 18 Months Follow-up Period

Abstract

DÍAZ, J.A.; HOPE, B. & JANS, A.Conservative and aesthetic emergency management in adolescent with complex crownroot fracture and simultaneous oblique root fracture in upper maxillary central incisor: clinical outcome after 18 months follow-up period. Int. J. Odontostomat., 6(1):27-37, 2012. SUMMARY:Emergency treatment of 11-years-old female patient, presenting a complicated crown root fracture, which simultaneously presented oblique root fracture in the maxillary right central incisor. In order to expose the subgingival extension of the fracture, it was necessary to raise a mucoperiosteal flap. In light of pulp exposure, and prior to the repositioning of fragments with adhesive composite resin technique, Cvek pulp therapy was performed . Despite the existence of a 4-5 mm subgingival extension, neither surgical nor orthodontic extrusion of the root fragment was performed due to the presence of intra-alveolar oblique root fracture without displacement. Minimally invasive and conservative clinical management is basic, namely due to the great capacity of pulp healing in young permanent teeth, the absence of displacement between fragments of root fracture, and great capacity of adhesion and tensile strength of current adhesive systems. Clinical and radiographic controls over the first 18 months have shown an excellent pulp response, with some minor periodontal complications in relation to the biological width invasion and an adequate functional and aesthetic result.

Long‐term results of crown fragment reattachment techniques for fractured anterior teeth: A retrospective case‐control study

“…However, the information of long‐term survival is rare and, mostly, includes the case‐reports, among which there are three works with a long observation period; and one stand‐alone multicenter clinical study of Andreasen et al (1995) . The latter study confirmed that the fragment reattachment was a realistic alternative to resin composite buildup for restoring esthetics and function to the traumatized dentition, and revealed the clinical factors that might predict fragment retention or loss and the frequency of pulpal complications .…”