Conservative Treatment of Complicated Oblique Crown-root Fractures of Molars: A Report of Five Representative Cases

2013 ◽  
Vol 38 (3) ◽  
pp. E67-E75 ◽  
Author(s):  
P Wang ◽  
W He ◽  
L Ni ◽  
Q Lu ◽  
H Sun

SUMMARY The five cases presented here describe a conservative treatment procedure for complicated crown-root fractures of molars with extensive loss of tooth structure. After the mobile crown-root fragments were extracted, the remaining crowns were restored at the juxtagingival level. The follow-up time ranged from two years, seven months, to four years. At the follow-up examinations, all of the teeth were asymptomatic and had healthy clinical appearances. There was no evidence of pockets related to fractures. The results of these cases show that complete periodontal healing is possible with conservative treatment of complicated crown-root fracture of molars.

2011 ◽  
Vol 2 (4) ◽  
pp. 338-341
Author(s):  
Ramya Raghu ◽  
DS Sahana

ABSTRACT Traumatic injury to oral cavity with accompanying tooth fracture can be a tragic experience for the patient and is a problem that requires experience, judgment and skill of the dentist. The dental health and appearance marred by an unsightly injury must be restored to normal as soon as possible. Though, root fractures comprise 0.5 to 7% of injuries affecting the permanent dentition, improper and delayed treatment can lead to loss of tooth. This report records a clinical case of intraalveolar horizontal mid root fracture in maxillary right central incisor with subluxation of coronal segment, which was managed endodontically using mineral trioxide aggregate (MTA), as an apical barrier at the fracture site. Maxillary right lateral and left central incisors affected by oblique crown-root fracture which were restored by custom-cast post and crown. After one year follow-up, the teeth were asymptomatic and showed signs of healing apical to the MTA barrier.


2013 ◽  
Vol 38 (2) ◽  
pp. 117-121 ◽  
Author(s):  
Vinaya Kumar Kulkarni ◽  
Raja Sridhar ◽  
Mahesh Kumar Duddu ◽  
Naveen Reddy Banda ◽  
Saket Vyawahare ◽  
...  

Crown-root fractures are one of the most challenging trauma cases to treat. Reattachment of tooth fragment to a fractured tooth being a simple procedure conserves the tooth structure, maintains the natural esthetics value and is thus considered as a favorable treatment option. The reattachment procedure using composite resin should be considered if the subgingival fracture can be exposed to provide isolation after a careful evaluation of the biologic width involvement. This case report presents a complicated crown-root fracture of permanent maxillay left central incisor, involving the biologic width in an 11-year-old boy. The traumatized tooth was treated endodontically and reinforced by using glass fiber-post. Access to the subgingival margins was gained by electro surgery. The fractured fragment was reattached using bonding system and composite resin.


Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 725
Author(s):  
David Marinčák ◽  
Vojtěch Doležel ◽  
Michal Přibyl ◽  
Iva Voborná ◽  
Ivo Marek ◽  
...  

The complicated crown-root fracture of young permanent teeth is an uncommon traumatic dental injury that is usually treated in a complex way and is demanding not only for the dentist but even for the treated child. In this case report, we present the conservative treatment of a maxillary central incisor in a 10-year-old boy after a traumatic dental injury. Treatment included partial pulpotomy and adhesive fragment reattachment after reflection of the mucoperiosteal flap. The patient was fully asymptomatic at 24-month follow-up, with an aesthetically acceptable outcome. Vital pulp therapy and adhesive fragment reattachment can be a viable treatment option for complicated crown-root fractures, especially when treating immature permanent teeth.


2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
I. Kanimozhi ◽  
Mahesh Ramakrishnan ◽  
Dhanalakshmi Ravikumar ◽  
Ningthoujam Sharna

Complicated crown-root fractures of primary teeth often present with a greater challenge to the pediatric dentist. Extraction of the involved tooth is the routine treatment indicated. But, early loss of this primary tooth may lead to esthetic and psychological problems and also causes a detrimental effect on the development of occlusion and the alveolar bone. The present case report described the management of crown-root fracture in a primary canine by surgical extrusion and showed a satisfactory prognosis at one-year follow-up.


2021 ◽  
Author(s):  
MD Alves ◽  
MA Tateyama ◽  
NNO Pavan ◽  
AF Queiroz ◽  
MCP Nunes ◽  
...  

SUMMARY Treatment of complicated crown-root fractures is one of the most challenging within the various types of dental trauma and requires a multidisciplinary approach. This paper reports the complicated crown-root fracture of a maxillary right central incisor, in which there was esthetic, functional, and biologic (endodontic and biologic width invasion) involvement. A 15-year-old male patient presented to the dental clinic one month after suffering trauma with a complicated crown-root fracture on tooth 8. The patient had previously undergone endodontic treatment and was sent to have periodontal surgery to reestablish the biological width on the palatal surface. Following the surgery, a fiberglass post was cemented, and the fragment was reattached. This approach allows the exposure of the cervical margin, adequate isolation, and subsequent fragment reattachment in the same clinical appointment. Fragment reattachment is a viable approach as it is a simple and conservative procedure that restores the natural esthetic of the tooth and has superior resistance compared to a composite restoration. The patient’s cooperation in understanding the limitations of the treatment and maintaining adequate oral hygiene are very important to achieving a good prognosis of the case. After a 2-year clinical and radiographic follow-up period, the clinical protocol was found to be successful, and the tooth remained functional, esthetically favorable and asymptomatic.


2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
S. Nagarajan M. P. Sockalingam ◽  
Katherine Kong Loh Seu ◽  
Halimah Mohamed Noor ◽  
Ahmad Shuhud Irfani Zakaria

Complicated crown-root fractures account for a small percentage of traumatic dental injuries seen in children; however, management of these injuries can be very challenging to clinicians. Factors such as complexity of the injury, patient’s age and dentition stage, patient’s cooperation, and parental demands may have some bearing on the type of treatment undertaken and its outcomes. In some children, these injuries may have significant impact on their quality of life. The purpose of this article is to describe two cases of complicated crown-root fracture which were successfully managed through orthodontic extrusion using a sectional fixed orthodontic technique. The basis for the treatment technique and its favourable outcomes were highlighted with its advantages and drawbacks.


2021 ◽  
Vol 10 (3) ◽  
pp. e30710313144
Author(s):  
Hugo José Santos Bastos ◽  
Key Fabiano Souza Pereira ◽  
Luiz Fernando Tomazinho ◽  
Marcos Roberto dos Santos Frozoni ◽  
Élida Boaventura Mendes

Root fractures can involve the dentin, cementum, and pulp and commonly can occur as oblique fractures with varying orientations. The aim of this study was to demonstrate the maintenance of pulp health in a tooth with a fractured root without any endodontic treatment and to discuss the advantage of cone-bean computed tomography (CBCT) compared with traditional radiographs in the diagnosis of oblique root fractures. Intra-oral radiography of tooth 11 revealed a horizontal root fracture at the level of the apical third, while the sagittal CBCT slice reveals a complete fracture line running obliquely from the apical third on the buccal aspect through the cervical third on the palatal aspect.  Four years follow-up, the tooth has kept its pulp vitality, no tooth discoloration or discrepancy in arch position, without endodontic treatment. This result illustrates spontaneous healing of root fracture including preservation of pulp health. In addition, it confirms the importance of exams in 3 dimensions to correctly locate the fracture and assist in the treatment decision.


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