Treatment outcomes after uncomplicated and complicated crown fractures in permanent teeth

Abstract

Objectives The 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 methods This 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. Results The 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. Conclusion The treatment of crown fractures resulted mostly in successful outcomes and only a moderate number of complications were observed. Clinical relevance Primary dental management of crown fractures should follow recently published clinical guidelines, and close monitoring over at least 2 years seems to be justified.

Present status and future directions: Endodontic management of traumatic injuries to permanent teeth

“…In contrast to VPT of cariously exposed pulps where HCSCs clearly outperform calcium hydroxide in terms of clinical success (ESE, 2019b), in the treatment of traumatically exposed pulps, the capping material (calcium hydroxide vs. HCSC) does not seem to be a decisive factor (Bissinger et al, 2021; Dammaschke et al, 2019a). A retrospective study demonstrated a significantly higher success rate when a new generation of HSCS was used instead of calcium hydroxide, however the latter still achieved a clinical success rate of 93% (Rao et al, 2020).…”

Retrospective analysis of the outcomes of pulpotomies in traumatised permanent anterior teeth

“…Cvek 23 found that all cases of PN after partial pulpotomy could be diagnosed within 26 months following treatment and he proposed the need for a 3‐year follow‐up period. Similarly, Bissinger et al 19 reported that the mean time interval for PN was 280.9 days (9.2 months), and most cases of PN occurred within the first 2 years after the injury. The IADT recommends clinical and radiographic evaluations after 6–8 weeks, 3, 6 months and 1 year 1 .…”

“…Reattachment of tooth fragments provides a conservative, aesthetic and cost‐effective restorative option. Furthermore, reattachment of the fragment does not affect pulp outcomes in the management of CCF 19 . Andreasen et al 20 reported retention rates of 20% and 25% after 7.5 and 10.5 years, respectively, for rebonded fragments.…”

Prevalence of Complicated and Uncomplicated Crown Fracture in Permanent Teeth Children Age 7-12years

“…[11,12] A common endodontic complication is the loss of pulp vitality, which was more prevalent in patients with additional luxation. [13] In this cross-sectional study 359 patients of both genders with 525 permanent teeth were presented. Patients were aged between 7-12 years with mean age 8.64 ±12.37 years.…”