Complicated crown fractures – management and treatment options

Abstract

Proper diagnosis, treatment planning and follow-up care are important factors in the prognosis of complicated crown fractures. Thorough understanding of the available treatment modalities and their specific indications is critical. The risks and benefits of each treatment option should be carefully evaluated during the treatment planning process.

Multidisciplinary Management of Subgingivally Fractured Maxillary Incisor: A Clinical Case Report

“…The major limitation of this approach is that it is relatively long, expensive, uncomfortable to the patient and surgical intervention is still necessary [11]. Thus, the technique requires multiple visits and patient cooperation [12]. By contrast, surgical crown lengthening is a faster procedure but involves removing the supporting alveolar bone, produces a high gingival contour, hampering soft tissue aesthetics and decreases the crown-root ratio [11,13].…”

Management of horizontal crown fracture caused by traumatic injury with endorestoration treatment

“…It is because this treatment could help the patient avoid anything more severe than soft-tissue edema. 6 Next, capturing printed images on his teeth 11, 12 and 21 which were traumatized was conducted before further treatment (Figure 1). Then, the maxillary and mandibular tooth anatomy was printed both for the study model and dental record, and also for diagnosing occlusion and relation that might occur as well as for preparing jacket crowns on teeth 11 and 12 in order not to reduce the esthetics of those teeth during the treatment.…”

“…Various kind of fractures usually occur because of severe trauma, 3% of which are caused by traffic accidents and trauma obtained at the time of exercise, while others are caused by trauma obtained in crime and rape cases. 6,7 In addition, strong frontal and horizontal force can produce fracture line from some point on crown to mesial or distal subgingival regions with or without the involvement of pulp. According to Ellis, the classification of dental fractures consists of six basic categories, namely: enamel fractures, dentin fractures without pulp exposure, crown fractures with pulp exposure, root fractures, luxation teeth, and intrusion.…”

“…2 It is because the degree of pulp exposure can vary from small open pulp to fully open coronal pulp. 6,8,9 There are four kinds of possible treatments for horizontal crown fracture with pulp exposure: pulpotomy (vital pulp), apexification (necrotic pulp), pulpectomy (endodontic treatment), and root resection. 10 In dentistry, especially in esthetic restoration, horizontally fractured crown with pulp exposure needs to obtain endorestoration treatment involving endodontic therapy using retention, such post core and jacket porcelain crown.…”

Management of Complicated Crown-Root Fracture by Fragment Reattachment Using Fibre-Post: An Aesthetic Alternative

“…(1) Choosing a treatment approach for a complicated crown fracture depends on the level and position of tooth fracture line, availability of displaced tooth fragments, type of occlusion, and prognosis. (2,3) Improvements in adhesive dentistry have enabled a conservative approach by reattachment of the fragment when it is present or reconstruction with composite resins.…”