Management Of Crown-root Fracture Research Articles

Management of crown-root fracture by orthodontic extrusion

Management of crown-root fracture by orthodontic extrusion

Tooth loss following surgical extrusion of crown-root fractured teeth: A 6-years survival analysis

Aim: This study aimed to show the adverse effect of surgical extrusion technique in the management of crown-root fractures regarding tooth loss over a six-year follow-up period.Methods: Twenty patients with a crown-root fracture in maxillary incisors were selected from an outpatient clinic in pediatric dentistry department- Cairo University. Twelve males and eight females with age range from 11-14 years participated in this study. Surgical extrusion was performed combined with endodontic treatment. Patients were recalled every year following surgical extrusion to assess the risk of tooth loss.Results: Twenty patients participated in this study with mean age of 131 months. Only 17 patients completed a follow-up period of at least one year. Overall, five teeth were lost over a follow-up period of six years constituting 29% (95% CI 13 to 53%) of the study population.Conclusion: Surgical tooth extrusion could be considered as a treatment option for crown-root fractures. Nevertheless, tooth loss is not an uncommon adverse effect. The first two years are critical for deciding the survival of surgical extruded tooth.

Multidisciplinary approach for esthetic management of crown-root fracture: Orthodontic extrusion and prosthetic rehabilitation

Fracture of anterior teeth poses functional as well as esthetic implications. Subgingival fractures are often treated by extraction of tooth followed by implant placement or a conventional fixed partial denture due to absence of adequate ferrule at the fracture site. Orthodontic extrusion/forced eruption can aid in the traction of fractured plane coronal to the gingival level, providing enough tooth structure for prosthetic rehabilitation. Since the surrounding periodontium also remodel during tooth extrusion, periodontal intervention may be required for their recontouring leading to a more esthetic final result. Endodontics need to be carried out when the pulp is involved due to traumatic injury. This kind of multidisciplinary approach can save many teeth with subgingival fracture from extraction. It can save the patient from the stress of extraction, especially at young age.

Finite element analysis of the maxillary central incisor with traditional and modified crown lengthening surgery and post-core restoration in management of crown-root fracture

To construct three-dimensional finite element models with modified crown lengthening surgery and post-core restoration in management of various crown-root fracture types, to investigate the intensity and distribution of stressin models mentioned above, and to compare and analyze the indications of traditional and modified crown lengthening surgeries from the mechanic point of view. Nine three-dimensional finite element models with modified crown lengthening surgery and post-core restoration were established and analyzed by micro-CT scanning technique, dental impression scanner, Mimics 10.0, Geomagic studio 9.0 and ANSYS 14.0 software. The von Mises stress of dentin, periodontal ligament, alveolar bone, post and core, as well as the periodontal ligament area and threshold limit value were calculated and compared with the findings of traditional crown lengthening models which had been published earlierby our research group. The von Mises stress intensity of modified crown lengthening models were: dentin>post>core>alveolar bone>periodontal ligament. The maximum von Mises stress of dentin(44.37-80.58 MPa)distributed in lingual central shoulder. The periodontal ligament area of the modified crown lengthening surgery was reduced by 6% to 28%, under the same crown-root fracture conditions, the periodontal ligament area of modified crown lengthening models was larger than that of the traditional crown lengthening models. In modified crown lengthening surgery models, the von Mises stress of periodontal ligament of B3L1m, B3L2m, B3L3m models exceeded their limit values, however, the von Mises stress of periodontal ligament of the B2L2c, B2L3c, B3L1c, B3L2c, B3L3c models exceeded their limit values in traditional crown lengthening surgery models. The modified crown lengthening surgery conserves more periodontal supporting tissues, which facilitates the long-term survival of teeth. The indication of modified crown lengthening surgery is wider than traditional method. The maxillary central incisors with labial fracture at gingival margin level and with palatal fracture at or below the alveolar crest level are not the indication of the crown lengthening surgery.

Management of Crown Root Fracture by Multi-disciplinary Approach-A Case Report

Trauma to anterior tooth is a relatively common event. Crown-root fractures are often difficult to treat and are time consuming, which causes psychological trauma to the patient during that period. Fracture of tooth after trauma is distressing to a person because of the discomfort and pain due to pulpal injury. Crown root fractures of anterior teeth cause concomitant periodontal injury and there will be concern about appearance and aesthetics. Management of pulpal and periodontal tissue relieves pain and restoration of tooth form regains patient’s confidence. Restoration of fractured tooth will be accepted readily if it is minimally invasive, less expensive, and aesthetically acceptable. Reattachment is an option for restoration of anterior teeth compared to other artificial replacements because of its appearance as natural. This method is favourable when the fractured fragment is intact and available. Utilization of pulp space for retention of fragment is achieved by the insertion of a dentine bonding post. This case report describes a case of tooth reattachment after trauma in which the pulp space is utilized to bond a fibre-reinforced post for retention after periodontal tissue management.

Aesthetic rehabilitation of a complicated crown-root fracture of the maxillary incisor: combination of orthodontic and implant treatment.

The aim of this paper is to present a complex rehabilitation, of fractured tooth, with implants in anterior region considering the orthodontics extrusion to clinical success. At 7 years old, the patient fractured the maxillary left central incisor and the dentist did a crown with the fragment. Twenty years later, the patient was referred to a dental clinic for orthodontic treatment, with the chief complaint related to an accentuated deep bite, and a professional started an orthodontic treatment. After sixteen months of orthodontic treatment, tooth 21 fractured. The treatment plan included an orthodontic extrusion of tooth 21 and implant placement. This case has been followed up and the clinical and radiographic examinations show excellence esthetic results and satisfaction of patient. The forced extrusion can be a viable treatment option in the management of crown root fracture of an anterior tooth to gain bone in a vertical direction. This case emphasizes that to achieve the esthetic result a multidisciplinary approach is necessary.

Management of Crown Root Fracture by Interdisciplinary Approach

Fracture of tooth after trauma is distressing to a person because of the discomfort and pain due to pulpal injury. Crown root fractures of anterior teeth cause concomitant periodontal injury and there will be concern about appearance, and aesthetics. Management of pulpal and periodontal tissue relieves pain and restoration of tooth form regains patients confidence. Restoration of fractured tooth will be accepted readily if it is minimally invasive, less expensive, and aesthetically acceptable. Reattachment is an option for restoration of anterior teeth compared to other artificial replacements because of its appearance as natural. This method is favourable when the fractured fragment is intact and available. Utilization of pulp space for retention of fragment is achieved by the insertion of a dentine bonding post. This case report describes a case of tooth reattachment after trauma in which the pulp space is utilized to bond a fiber-reinforced post for retention after periodontal tissue management.

Management of crown root fractures: A novel technique with multidisciplinary approach

Crown root fractures with subgingival extent are difficult to manage as the biologic width is difficult to maintain. Various treatment options range from conservative reattachment procedure to radical procedures like extraction. One among them is forced eruption or orthodontic extrusion. A novel technique is reported in the management of fractured anterior tooth using the method of forced eruption. This case report gives an option of multidisciplinary approach that does not compromise the aesthetics even during the treatment.

Management of crown-root fracture in mandibular first primary molar caused by injury to the chin

Dental traumas are highly prevalent lesions in primary teeth, but crown-root fractures are seldom observed in primary molars. When trauma is sustained to the chin, the posterior primary teeth are at increased risk of trauma. The treatment of fractured teeth can be complicated, sometimes because of difficulties with the final restoration. A 4-year-old girl was referred to a Specialty Dental clinic by a general dental practitioner with complaints of pain in her left mandibular posterior teeth region while biting. History revealed that she had fallen ten days before while playing. Chin laceration was sutured in the trauma centre, but no dental treatment was carried out. She was subsequently discharged. Later, she had pain while biting for which she was referred to the clinic by her general dental practitioner. Extra-oral examination demonstrated a healing laceration on the chin. Radiographic examination showed the presence of an unusual complicated crown-root fracture of the left mandibular first primary molar. Pulpectomy was carried out and the fracture was stabilised with glass ionomer cement and a preformed metal crown was placed. Patient was reviewed after 3, 6 and 12 months both radiographically and clinically. Though radiographically it was found that the obturating material was resorbed completely at the 12 month visit, clinically the patient was asymptomatic until now (after 15 months). The patient is still under review. This case highlights the need for a systematic history and examination in all cases of dental trauma. It also demonstrates that conservative management is possible and not all primary teeth with crown-root fractures need to be extracted.

Management of crown root fracture in primary ‘double tooth’: a case report

The term 'double tooth' is used to describe two developmental dental anomalies of shape: gemination and fusion. Traumatic episodes involving a fused or geminated primary tooth are rare. This report describes an unusual case of crown root fracture in a primary double tooth.