Treatment outcomes after uncomplicated and complicated crown fractures in permanent teeth

Ricarda Bissinger,Daniel David Müller,Yegane Khazaei,Jan Kühnisch,Marcel Reymus,Reinhard Hickel,Katharina Bücher

doi:10.1007/s00784-020-03344-y

Ricarda Bissinger, Daniel David Müller + Show 5 more

Open Access

https://doi.org/10.1007/s00784-020-03344-y

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Abstract

ObjectivesThe objectives of this retrospective clinical study were to describe characteristics of crown fractures in permanent teeth and to investigate the survival of pulp vitality and restorations in uncomplicated and complicated crown fractures.Materials and methodsThis retrospective study collected information from patients suffering from dental trauma who were treated between January 2004 and June 2017. The study population consisted of 434 patients (253 males/181 females; mean age 20.7 years) with 489 uncomplicated and 127 complicated crown fractures. The Kaplan-Meier survival curves and Cox proportional hazard regression analyses were performed to explore the data statistically.ResultsThe mean observation time was 522 days. Uncomplicated crown fractures without luxation showed a higher success rate of 82.3% (345/419) than complicated crown fractures without luxation (72.3%, 73/101). An additional luxation in uncomplicated crown fractures resulted in significantly reduced success rates in terms of survival of the pulp and restoration. Direct restorations survived significantly better independent of the fracture mode than did adhesively reattached crown fragments. No superiority of mineral trioxide aggregate or calcium hydroxide as pulp capping agent in complicated crown fractures was documented. Approximately 85.5% of all complications occurred within 2 years after the accident.ConclusionThe treatment of crown fractures resulted mostly in successful outcomes and only a moderate number of complications were observed.Clinical relevancePrimary dental management of crown fractures should follow recently published clinical guidelines, and close monitoring over at least 2 years seems to be justified.

Highlights

Dental trauma is a frequent incident in permanent dentition and can occur in all stages of life, with increased numbers documented in the first and second decades of life [1, 2]
Ethical approval was obtained from the Human Ethics Committee of the Medical Faculty of the Ludwig-Maximilians-University, Munich (Project no. 67016). This retrospective study collected information from patients suffering from dental trauma who were treated at the Department of Conservative Dentistry and Periodontology at Ludwig-Maximillians-University in Munich, Germany, between January 2004 and June 2017
Of the whole study population, 434 patients (253 males/181 females; mean age of 20.7 years; range 6–86 years) with a total of 616 teeth were affected by a(n)complicated crown fracture (616/1344 teeth; 45.8% of all traumatized teeth in the permanent dentition)

Summary

Introduction

Dental trauma is a frequent incident in permanent dentition and can occur in all stages of life, with increased numbers documented in the first and second decades of life [1, 2]. When considering the spectrum of injuries, crown fractures with or without pulp exposure are the most frequently recorded types of dental trauma [3, 4]. Clin Oral Invest (2021) 25:133–143 study were to describe characteristics of crown fractures in permanent teeth and to provide longevity information about the survival of teeth, pulp, and restorations in relation to the fracture and luxation patterns. The null hypothesis formulated that the survival of pulp vitality and restoration would be distributed in relation to the type of injury

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