Multidisciplinary approach for management of traumatic subgingival crown-root fractured central incisor: A case report

Kishan Agarwal,Shreya Shreya,Ritwik Shyamal,Praveen Singh Samant,Nikhil Ashok

doi:10.18231/j.ijce.2020.006

Abstract

Multidisciplinary approach for management of traumatic subgingival crown-root fractured central incisor: A case report - IJCE- Print ISSN No: - 2581-9534 Online ISSN No:- 2581-8988 Article DOI No:- 10.18231/j.ijce.2020.006, IP Indian Journal of Conservative and Endodontics-IP Indian J Conserv Endod

Highlights

Recently the incidences of traumatic injuries to the anterior teeth have been increased as an outcome of leisure activities, where the crown fractures are most common
Crown-root fractures are very common but due to the complexity of the injury, these are frequently presented with the treatment problems.[1]
Dental trauma associated with complicated fracture in permanent anterior teeth, can be one of the most difficult situation in dental practice which demands a comprehensive treatment planning

Summary

Introduction

The incidences of traumatic injuries to the anterior teeth have been increased as an outcome of leisure activities, where the crown fractures are most common. Orthodontic extrusion[10] is a conservative procedure for raising the fracture line above the epithelial margins by elevating the sound tooth structure within the socket that makes it easier to prepare the proper finishing margins.[11] This case report describes a multidisciplinary approach using orthodontic extrusion, followed by gingivectomy to facilitate the endodontic restoration of a subgingivally fractured maxillary permanent central incisor. Radiograph examination showed that the root had sufficient length, width and matured apex without any fracture, to be considered for extrusion (Fig. 3) and it was associated with periapical radiolucency and periodontal widening Treatment aims These were as follows:[1]. #11; post and core build-up of tooth #11; Fig. 6,7: Clinical evidence of increased crown length after forced orthodontic extrusion of tooth #11; Fig. 11:Clinical picture showing uneven crown margins of tooth #11 after extrusion; Fig. 8: Palatal aspect of tooth #11 showing fracture margin at gingival level; Fig. 12,13: Clinical picture post Laser assisted Crown lengthening to achieve proper contouring of tooth #11; Fig. 9: Radiographic representation of extruded tooth #11

Discussion

Findings

Conclusion