Abstract
Treatment of crown root fracture is complex and requires an accurate diagnostic and treatment plan. The purpose of this article is to report a case of a maxillary central incisor with a crown-root fracture with pulp exposure treated and rehabilitated with the preservation of pulp vitality using a micro-pulpotomy and pre-mixed bioactive endodontic cements followed by zirconia restauration, a bioinert ceramic material, milled using CAD/CAM technology. The preservation of pulp vitality using premixed bioceramic materials, ensures the continuation of dentinogenesis with its benefits, higher resistance of radicular walls against fracture, smaller diameter of apical foramen as well as creating conditions over time for a post retained crown with better aesthetic results.
Highlights
Treatment of crown root fracture is complex and requires an accurate diagnostic and treatment plan
The purpose of the present paper is to describe the advantages of using the pre-mixed bioactive endodontic cements for pulpotomy procedures in a crown-root fracture with pulp exposure
When bioceramic materials make contact with tissue fluids they release calcium hydroxide which can interact with the phosphates in the tissues to form hydroxyapatite, showing the inductive properties of the material
Summary
Treatment of crown root fracture is complex and requires an accurate diagnostic and treatment plan. The purpose of the present paper is to describe the advantages of using the pre-mixed bioactive endodontic cements for pulpotomy procedures in a crown-root fracture with pulp exposure. The recommended emergency treatment is a temporary stabilization of the loosed segment to adjacent teeth These fractures occur in young teeth with open apices and it is advantageous to preserve the pulp vitality using a partial pulpotomy. Endodontic premixed bioceramics are bioactive materials with similar chemical composition: calcium silicates, calcium phosphate monobasic, zirconium oxide, tantalum oxide, fillers. They were developed by a Canadian research company in 2008 (Innovative BioCeramix, Inc., Vancouver Canada) since are available as EndoSequence® BC SealerTM, EndoSequence® BC RRMTM (Root Repair Material, syringable paste) and EndoSequence® BC RRM Fast Set PuttyTM. The clinical examination showed a complicated crown-root fracture with pulpal involvement and concussion in the maxillary left central incisor and an enamel crown fracture (mesio-incisal angle) in the maxillary right central incisor
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