Multidisciplinary Approach in the Rehabilitation of Complicated Crown-root Fracture: A Case Report

Hemanta Halwai,Nisha Acharya,Ourvind Singh,Praveen Singh Samant,Vanita Gautam

doi:10.3126/ojn.v4i2.13899

Abstract

The management of patients with traumatic injuries to their dentition poses a serious challenge in everyday general dental practice. For the rehabilitation of the complicated subgingival crown fracture of anterior teeth, multidisciplinary approach is often indicated. A combination of endodontic, orthodontic, periodontal and prosthodontic approach may be required. Orthodontic or periodontal intervention becomes an integral part for the exposure of the sound tooth structure of fractured anterior teeth with fracture line extending subgingivally. The aim of this paper is to discuss the immediate endodontic management followed by orthodontic extrusion of traumatized upper anterior teeth with fracture at the subgingival level. In order to expose the sound tooth structure for prosthodonticintervention, orthodontic extrusion was performed after endodontic treatment. To avoid extraction of the involved teeth, the multidisciplinary approach was adopted and finally the teeth were restored prosthodontically. The final result was esthetically pleasant and periodontically sound.

Highlights

Dental traumatic injuries are mostly unanticipated events that pose serious consequences for the patient if not managed timely with the appropriate treatment
In primary dentition luxation injuries are the most common Traumatic dental injuries (TDIs) whereas crown fractures are more commonly seen with the permanent dentition.[1,2]
It has been reported that the most TDIs occur during the first two decades of life and 70% of such injuries involve the maxillarycentral incisors followed by maxillary lateral incisors and mandibular incisors.[3]

Summary

INTRODUCTION

Dental traumatic injuries are mostly unanticipated events that pose serious consequences for the patient if not managed timely with the appropriate treatment. Car crashes, contact sports or foreign bodies hitting the teeth are the most common causes of crown or crown-root fractures in the permanent dentition.[5]. TDIs can result in damage to both dental and periradicular structures. It may cause pulpal injury with or without crown and/or root fracture.TDIs have been classified on the basis of several factors such as etiology, anatomy, pathology, therapeutic considerations and degree of severity.[6] In 1955, the World Health Organization (WHO) published the Application of the International Classification of Diseases to Dentistry and Stomatology, with a comprehensive classification of fractures of the teeth[7] which includes: 1. According to Backland and Andreason,[5,8] TDIs can be of following types:

Root fracture

Findings

DISCUSSION