Management of Complicated Crown Fractures in Vital Immature Incisors

Authors

1 Department of Paediatric Dentistry, Razavi Hospital, Mashhad, IR Iran

2 Department of Endodontics, Razavi Hospital, Mashhad, IR Iran

Abstract

Introduction: Dental trauma is one of the most serious oral conditions especially among children. It frequently occurs in children from 6 to 13 years old, often involving teeth with incomplete root formation. The most common dental injury at this age is crown fracture. Arguments: To provide this clinical guide, Pubmed and Scopus were searched using the following keywords: Immature, Incisor and Pulpotomy. More importantly, the latest clinical guidelines provided by the International Association for Dental Traumatology, British Society of Paediatric Dentistry, and the Royal College of Surgeons of England and National Institute for Health and Care Excellence were studied and incorporated into this paper (Grade 1 evidence). Conclusions: Management of a young patient who has sustained such trauma includes a wide range of options based on the clinical and radiographic findings. Here we explain in detail the latter as well as covering available literature and guidelines.

Keywords

References

  1. 1.Andreasen JO, Ravn JJ. Epidemiology of traumatic dental injuries to primary and permanent teeth in a Danish population sample. Int J Oral Surg. 1972;1(5):235–9. [PubMed: 4146883]

    1. Andreasen JO, Andreasen FM, Bakland LK, Flores MT. Traumatic dental injuries: A manual. 2nd ed. Oxford: Blackwell Science; 2003.
    2. Zerman N, Cavalleri G. Traumatic injuries to permanent incisors. Endod Dent Traumatol. 1993;9(2):61–4. [PubMed: 8404697]
    3. Andreasen JO, Andreasen FM. Essentials of traumatic injuries to the teeth. 2nd ed. Copenhagen: Blackwell Munksgaard; 2000.
    4. O'Brien M, O'brie M. Children's dental health in the United Kingdom 1993. London, UK: HM Stationery Office; 1994.
    5. Hamilton FA, Hill FJ, Holloway PJ. An investigation of dentoalveolar trauma and its treatment in an adolescent population. Part 1: The prevalence and incidence of injuries and the extent and adequacy of treatment received. Br Dent J. 1997;182(3):91–5. [PubMed: 9055474]
    6. Glendor U. Epidemiology of traumatic dental injuries--a 12 year review of the literature. Dent Traumatol. 2008;24(6):603–11. doi: 10.1111/j.1600-9657.2008.00696.x. [PubMed: 19021651]
    7. Bastone EB, Freer TJ, McNamara JR. Epidemiology of dental trauma: a review of the literature. Aust Dent J. 2000;45(1):2–9. [PubMed: 10846265]
    8. Stockwell AJ. Incidence of dental trauma in the Western Australian School Dental Service. Community Dent Oral Epidemiol. 1988;16(5):294–8. [PubMed: 3263252]
    9. Perez R, Berkowitz R, McIlveen L, Forrester D. Dental trauma in children: a survey. Endod Dent Traumatol. 1991;7(5):212–3. [PubMed: 1687388]
    10. Burden DJ. An investigation of the association between overjet size, lip coverage, and traumatic injury to maxillary incisors. Eur J Orthod. 1995;17(6):513–7. [PubMed: 8682168]
    11. Castro JC, Poi WR, Manfrin TM, Zina LG. Analysis of the crown fractures and crown-root fractures due to dental trauma assisted by the Integrated Clinic from 1992 to 2002. Dent Traumatol. 2005;21(3):121–6. doi: 10.1111/j.1600-9657.2005.00276.x. [PubMed: 15876320]
    12. Jackson NG, Waterhouse PJ, Maguire A. Factors affecting treatment outcomes following complicated crown fractures managed in primary and secondary care. Dent Traumatol. 2006;22(4):179–85. doi: 10.1111/j.1600-9657.2006.00369.x. [PubMed: 16872386]
    13. Zadik Y. Oral trauma and dental emergency management recommendations of first-aid textbooks and manuals. Dent Traumatol. 2007;23(5):304–6. doi: 10.1111/j.1600-9657.2006.00443.x. [PubMed: 17803488]
    14. Cvek M. Endodontic Management of Traumatized Teeth. In: Andreasen JO, Andreasen FM, editors. Textbook and Color Atlas of Traumatic Injuries to The Teeth. 3rd ed. Copenhagen: Muksgaard; 1993. pp. 517–85.
    15. Curzon MEJ, Duggal MS, Fayle SA, Toumba KJ. Handbook of dental trauma: a practical guide to the treatment of trauma to the teeth. Oxford: John E Wright & Co Ltd; 1999.
    16. Cavalleri G, Zerman N. Traumatic crown fractures in permanent incisors with immature roots: a follow-up study. Endod Dent Traumatol. 1995;11(6):294–6. [PubMed: 8617166]
    17. Ravn JJ. Follow-up study of permanent incisors with complicated crown fractures after acute trauma. Scand J Dent Res. 1982;90(5):363–72. [PubMed: 6960466]
    18. Cvek M. A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture. J Endod. 1978;4(8):232–7. doi: 10.1016/S0099- 2399(78)80153-8. [PubMed: 283188]
    19. Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F, et al. Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth. Dent Traumatol. 2007;23(2):66–71. doi: 10.1111/j.1600-9657.2007.00592.x. [PubMed: 17367451]
    20. Fuks AB, Cosack A, Klein H, Eidelman E. Partial pulpotomy as a treatment alternative for exposed pulps in crown-fractured permanent incisors. Endod Dent Traumatol. 1987;3(3):100–2. [PubMed: 3476297]
    21. Strobl H, Emshoff I, Bertram S, Emshoff R. Laser Doppler flow investigation of fractured permanent maxillary incisors. J Oral Rehabil. 2004;31(1):23–8. [PubMed: 15125592]
    22. Ravn JJ. Dental injuries in Copenhagen schoolchildren, school years 1967-1972. Community Dent Oral Epidemiol. 1974;2(5):231–45. [PubMed: 4154162]
    23. Alonge OK, Narendran S, Williamson DD. Prevalence of fractured incisal teeth among children in Harris County, Texas. Dent Traumatol. 2001;17(5):218–21. [PubMed: 11678541]
Razavi International Journal of Medicine
Volume 3, Issue 4
October 2015
Pages 31-34

Files

Share

How to cite

Statistics