Abstract
ABSTRACT Multiple clinical specialties are usually needed for a successful long-term treatment in buccal cavity. The aim of this article is to report a clinical case of multi-disciplinary rehabilitation of fracture upper incisors without pulp exposure, concerning about endodontics, periodontics and restorative dentistry comments or procedures. A case of a patient reporting trauma that resulted in fracture and substantial loss of hard tissue, in mesial angle of both upper central incisors (11 and 21). In palatal side, fracture extended beyond cingulum up to subgingival region. Periodontal surgery was performed in order to reestablish biological space. Clinical and radiographic assessments demonstrated no need for endodontic treatment, since pulp was vital and non-altered. Preparations for restorative procedures were minimally invasive, followed by composite direct. A three-year follow-up was performed, consisting in re-assessment of clinical and radiographic aspects, re-polishing of the restorations and photographic documentation. No pulp tissue alteration was observed after the follow-up period. Restorative procedures, adjacent tissues and pulp vitality were considered adequate, and the patient was satisfied with the treatment.
Highlights
Treatment of dental fractures often involves different dental specialties due to its complexity
Dental trauma is considered an issue of public health, including 5% of all injuries that leads to dental treatment [3]
After examination of the amount of remaining tooth structure, it was decided that a direct restorative treatment with aesthetic composite resin was the best option
Summary
Treatment of dental fractures often involves different dental specialties due to its complexity. Dental element fracture is one type of trauma that may affect patient’s health, and can be classified as: enamel fracture, crown fracture (with or without pulp involvement), crownroot fracture (with or without pulp involvement) and root fracture [1]. The most affected teeth are the upper incisors, which fractures involving enamel and dentin are the most common trauma related by dentists [2]. Dental trauma impact may affect pulp and periodontal tissues, as well as surrounding alveolar bone [4]. Those damages should be evaluated, by clinical assessment, and by complementary image assessments. Periodontal tissue could be directly affected when fractures extends along biological width [1], resulting in chronic gingival inflammation and, subsequently, bone loss. In order to reduce this process, clinical procedures aiming to recover biological space previously to restorative treatments are mandatory [5]
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