Management of Crown Root Fracture by Interdisciplinary Approach

Abstract

Fracture of tooth after trauma is distressing to a person because of the discomfort and pain due to pulpal injury. Crown root fractures of anterior teeth cause concomitant periodontal injury and there will be concern about appearance, and aesthetics. Management of pulpal and periodontal tissue relieves pain and restoration of tooth form regains patients confidence. Restoration of fractured tooth will be accepted readily if it is minimally invasive, less expensive, and aesthetically acceptable. Reattachment is an option for restoration of anterior teeth compared to other artificial replacements because of its appearance as natural. This method is favourable when the fractured fragment is intact and available. Utilization of pulp space for retention of fragment is achieved by the insertion of a dentine bonding post. This case report describes a case of tooth reattachment after trauma in which the pulp space is utilized to bond a fiber-reinforced post for retention after periodontal tissue management.

Fragment reattachment after complicated crown‐root fractures of anterior teeth: A systematic review

“…Tooth mobility and percussion tests were used as diagnostic tests in six 13,15,22,25,28,29 and two articles, 13,29 respectively. In ten of the included articles, only a single straight angled pre‐operative intra‐oral periapical (IOPA) radiograph was taken for the assessment of the extent of fracture 10,12–15,22–25,27 . In addition to an IOPA, an orthopantomograph (OPG) 29 and a soft tissue radiograph 26 were taken in one article each.…”

“…Eight articles 10,15,16,24–26,28,29 reported that the fracture line was violating the biological width whereas, in four articles it was mentioned that there was no violation 13,14,22,27 . In two articles, detail regarding the extent of the fracture line was not mentioned 12,23 . The fractured coronal fragment was reported to be detached (avulsed) in two articles (1 case report and a tooth of a case series) 14,27 .…”

“…The fractured coronal fragment was reported to be detached (avulsed) in two articles (1 case report and a tooth of a case series) 14,27 . In all the remaining 13 articles (11 case reports, 1 case series and a tooth of a case series), 10,12,13,15,16,22–29 the coronal fragment was partially attached to the main tooth structure. The attached coronal fragment was removed in all cases and rehydrated using a storage medium.…”

Alveolar Ridge Preservation of an Extraction Socket of Fractured Maxillary Lateral Incisor

“…Bone graft as autogenic, allogenic, and heterogenic with or without barrier membrane, synthetic materials, platelet rich fibrin gives a good result for ARP [ In contrast to our case, the horizontal fractures are described in the central maxillary incisors in the literature. These conditions lead to aesthetic, functional, and healing problems [16]. According to Andreason et al [4], recovery of root fractures is divided into four different types: a) recovery with hard tissue, b) recovery with conjunctive tissue interposition, c) recovery with bone and conjunctive interposition between the fragments, and d) recovery with granulation tissue between the fragments.…”

Multidisciplinary Approach for the Treatment of Horizontal Root-Fractured Maxillary Anterior Teeth

“…Horizontal fractures usually occur in the central maxillary incisors. These fractures subsequently lead to aesthetic, functional, and phonetic problems [ 4 ], and healing from fractures can be complicated. Andreason et al [ 5 ] reported four different types of healing in root fractures: (a) healing with calcified tissue, (b) healing with conjunctive tissue interposition, (c) healing with bone and conjunctive interposition between the fragments, and (d) healing with granulation tissue between the fragments.…”