Delayed Treatment of Traumatized Primary Teeth with Distinct Pulp Response: Follow-Up until Permanent Successors Eruption

Abstract

Complicated crown fracture and crown-root fracture with pulp involvement expose dental pulp to the oral environment. The pulp outcome is often unpredictable because the patient and injury which are related to variables can influence the treatment of choice and the prognosis of the case. This report presents the case of a 4-year-old boy with complicated crown fracture with pulp polyp in the primary right maxillary central incisor (51) and crown-root fracture with pulp involvement in the primary left maxillary central incisor (61), which was treated only 3 months after the tooth injuries. The treatment of choice was extraction of tooth (61) due to a periapical lesion with disruption of the dental follicle of the permanent successor and pulpotomy (MTA) of the tooth (51), because the pulp presented signs of vitality. At the follow-up visits, no clinical, symptomalogical, and radiographic changes were observed until the primary tooth's exfoliation. However, at 3-year follow-up, the permanent successors showed hypocalcification and the position of the permanent right maxillary central incisors (11) was altered. Besides the conservative and adequate delayed treatment, the sequelae on the permanent successors could not be avoided.

Treatment outcomes after uncomplicated and complicated crown fractures in permanent teeth

“…With respect to these important clinical variables, the documented survival rates (Table 3 ) should not be misinterpreted to favour direct restorations in primary dental trauma care. Finally, it can be concluded from our data in comparison to existing information from the literature [ 31 – 33 ] that restorations placed in the present study were associated with high survival rates. When reporting the longevity of restorations, the clinician must also know the time intervals in which losses of restoration may occur.…”

Reason for visit to dentist following trauma to primary teeth-A one-year Retrospective study

“…Traumatic injuries to the primary teeth are the second most frequent cause of consultation in pediatric dental practice (Oliveira et al, 2017) Traumatic crown injuries are considered a public dental health problem due to its costs and treatment, which may persist for rest of patient's infancy. (Tello et al, 2016;Oliveira et al, 2017)) The most commonly affected primary teeth are upper central incisors and more than one tooth can lesioned. (Mendoza-Mendoza et al, 2015) Complicated crown fracture and crown root fracture with pulp involvement expose dental pulp to oral environment.…”