Abstract
Dental trauma is commonly occur in children and may involve adult person also. In permanent dentition crown fracture is common and it may be uncomplicated or complicated. Complicated crown-root fractures require a multidisciplinary treatment modality for longterm success. Here we presented multidisciplinary treatment of a traumatized permanent maxillary incisor of a young male patient where oblique tooth fracture involved coronal pulp. As more than 50% of the crown and palatal coronal part of the root had been fractured and the tooth could not be properly isolated during endodontic procedure which is essential for success of root canal treatment. An intra-canal wire hook was cemented in the root canal and attached to another wire fixed to the adjacent teeth. With the help of elastic band attached with hook the fractured tooth fragment was extruded to create clinical crown. Finally, gingival re-contouring was performed to establish optimum biological width. At last, porcelain fused to metal crown was placed and the patient was comfortable both esthetically and functionally.International Journal of Human and Health Sciences Vol. 03 No. 03 July’19. Page: 165-168
Highlights
There is recent trend and attitude towards dental implant after extraction that type of tooth. This option can be considered as last one. Treatment modality of this type of sub-gingivally fractured tooth should involve multi-disciplinary approach including endodontic, periodontal crown lengthening and/ or orthodontic extrusion followed by prosthetic rehabilitation
These procedures preserving optimum periodontal tissue health and esthetics.9There are many splints suggested using for orthodonticforced extrusion. 15g of extrusive force for incisor and 60g for a molar are required for successful tooth extrusion
A customized hook prepared by 7m.m s.s wire was luted in the root canal system of the fractured tooth and elastic traction acquired by another horizontal wire attached by composite restoration on adjacent five teeth i.e. canine tooth at left side to lateral incisor of right side
Summary
Accidental injury to tooth especially in the esthetic region poses a great challenge to a dentist in respect to maintain proper health and function. This option can be considered as last one Treatment modality of this type of sub-gingivally fractured tooth should involve multi-disciplinary approach including endodontic, periodontal crown lengthening and/ or orthodontic extrusion followed by prosthetic rehabilitation. Periodontal crown lengthening involves the removal of supporting crestal alveolar bone while orthodontic intervention forcibly extrudes the tooth. By both attempts sufficient coronal tooth structure can be achieved for proper prosthetic. Of Conservative Dentistry & Endodontics, Update Dental College & Hospital, Turag, Dhaka-1711. Periodontal crown lengthening may expose excess of root will eventually compromise esthetic results This condition can be achieved by the use of orthodontic extrusion.[1-6]. )LJXUH DEFGH D3DODWDOYLHZDIWHUJLQJLYDOFRQWRXULQJE$IWHU FURZQ FXW F$IWHU FXVWRP PDGH SRVW DQG FRUH SODFHPHQW G DIWHU ILQDOSURVWKHVLV
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