Crown-root fracture- a multidisciplinary approach
Fratura coronorradicular: uma abordagem multidisciplinar
Prado, Maíra do; Gomes, Brenda Paula Figueiredo de Almeida; Telles, Elise Lanziotti; Araújo, Marcos Cesar Pimenta de; Gusman, Heloísa Carla
Abstract
A crown-root fracture involves enamel, dentin and cementum. There may or may not be pulp involvement. Several treatments are proposed in the literature, going from a simple bond of dental fragments to surgical extrusion of the dental remaining fragments. The article describes a case of crown-root fracture with pulp involvement, and the multidisciplinary approach applied to the case. Case report: Patient required dental treatment due to a “broken tooth”. The treatment consisted in a mucoperiosteal flap to remove dental fragments, endodontic treatment, temporary restoration, orthodontic extrusion, a new restoration, and the follow-up of the case. Conclusion: While treating the anterior teeth of young patients, the orthodontic extrusion accompanied by restorative treatment is the most conservative and aesthetic option of treatment.
Keywords
Resumo
Uma fratura coronorradicular envolve esmalte, dentina e cemento, podendo ou não haver comprometimento pulpar. Vários tratamentos são propostos na literatura, desde a colagem do fragmento dental até a extrusão cirúrgica do fragmento remanescente. O presente trabalho descreve um caso de fratura coronorradicular com envolvimento pulpar e a abordagem multidisciplinar dada ao caso. Descrição do caso clínico: Paciente procurou tratamento odontológico por causa de um “dente quebrado”. O tratamento realizado consistiu em um retalho mucoperiosteal para remoção dos fragmentos dentais, tratamento endodôntico, restauração provisória, extrusão ortodôntica, uma nova restauração e a proservação do caso. Conclusão: Em pacientes jovens, na região anterior, a extrusão ortodôntica acompanhada do tratamento restaurador é uma opção de tratamento conservador e estético.
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Referências
1. Andreasen JO, Andreasen FM. Traumatismo dentário. São Paulo: Panamericana; 2001.
2. Turgut MD, Gönül N, Altay N. Multiple complicated crown-root fracture of a permanent incisor. Dent Traumatol. 2004;20:288‑92. PMid: 15355388
3. Häyrinen-Immonen R, Sane J, Perkki K, Malmstrom M. A six year follow-up study of sports related dental injuries in children and adolescents. Endod Dent Traumatol. 1990;6:208‑12. PMid: 1983467
4. Olsburgh S, Jacoby T, Krejei I. Crown fractures in the permanent dentition: pulpal and restorative considerations. Dent Traumatol. 2002;18:103-15. PMid: 12110103
5. Nysether S. Dental injuries among Norwegian soccer players. Community Dent Oral Epidemiol. 1987;15:141–3. PMid: 2885124
6. Wang Z, Heffernan M, Vann Jr WF. Management of a complicated crown-root fracture in a young permanent incisor using intentional replantation. Dent Traumatol. 2008;24:100‑3. PMid: 18173676
7. Altay N, Güngör HC. A retrospective study of dento- alveolar injuries of children in Ankara, Turkey. Dent Traumatol. 2001;17:201–4. PMid: 11678537
8. Aggarwal V, Logani A, Shah N. Complicated crown fractures - management and treatment options. Int Endod J. 2009;42:740-53. PMid: 19548932
9. Sheikh-Nezami M, Mokhber N, Shamsian Kh, Saket S. Management of a midroot and complicated crown fracture: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107:e65-e67. PMid: 19426910
10. Olsburg S, Jacoby T, Krejci I. Crown fractures in the permanent dentition: pulpal and restorative considerations. Dent Traumatol. 2002;18:103–15. PMid: 12110103
11. Çalıskan MK, Turkun M, Gomel M. Surgical extrusion of crown-root-fractured teeth: a clinical review. Int Endod J. 1999;32:146–51. PMid: 10371911
12. Kocadereli I, Taşman F, Güner SB. Combined endodontic- orthodontic and prosthodontic treatment of fractured teeth. Case report. Aust Dent J. 1998;43:28–31. PMid: 9583222
13. Koparal E, Ilgenli T. Reattachment of a subgingivally fractured central incisor tooth fragment: report of a case. J Clin Pediatr Dent. 1999;23:113–5. PMid: 10204451
14. Bondemark L, Kurol J, Hallonsten AL, Andreasen JO. Attractive magnets for orthodontic extrusion of crown-root fractured teeth. Am J Orthod Dentofacial Orthop. 1997;112:187–93. PMid: 9267231
15. Fidel SR, Fidel-Junior RA, Sassone LM, Murad CF, Fidel RA. Clinical Management of a complicated crown-root fracture: A case report. Braz Dent J. 2011;22:258-62. http://dx.doi.org/10.1590/S0103-64402011000300014
16. Glassman GD, Serota KS. Treating the apex last: the definitive endodontic paradigm. Oral Health. 1993;10:21-7.
17. Buchanan LS. The Continuous wave of Obturation Techinique Condension of Warm Gutta-percha in 12 seconds. Dent Today. 1996;1-7. PMid: 9567127
18. Lopes HP, Siqueira Jr JF. Endodontia. Biologia e técnica. Rio de Janeiro: MEDSI; 2004.
19. Cohen S, Burns RC. Caminhos da polpa. Rio de Janeiro: Guanabara Koogan; 2000.
20. Turkistani J, Hanno A. Recent trends in the management of dentoalveolar traumatic injuries to primary and young permanent teeth. Dent Traumatol. 2011;27:46-54.
21. Olsburgh S, Jacoby T, Krejci I. Crown fractures in the permanent dentition: pulpal and restorative considerations. Dent Traumatol. 2003;18:103–15. PMid: 21244628
22. Turgut MD, Gönül N, Altay N. Multiple complicated crown-root fracture of a permanent incisor. Dent Traumatol. 2004;20:288‑92. PMid: 15355388
23. Koyuturk AE, Malkoc S. Orthodontic extrusion of subgingivally fractured incisor before restoration. A case report: 3-years follow-up. Dent Traumatol.2005;21:174-8. PMid: 15876331
24. Healey DL, Plunkett DJ, Chandler NP. Orthodontic movement of two root fractured teeth: a case report. Int Endod J. 2006;39:324-9. PMid: 16584496
25. Malmgren O, Malmgren B, Frykholm A. Rapid orthodontic extrusion of crown root and cervical root fractured teeth. Endod Dent Traumatol. 1991;7:49-54. http://dx.doi.org/10.1111/j.1600-9657.1991.tb00183.x
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