International Journal of Clinical Pediatric Dentistry

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VOLUME 12 , ISSUE 1 ( January-February, 2019 ) > List of Articles

CASE REPORT

Revascularization of an Immature Permanent Central Incisor with Complicated Crown Root Fracture: A Case Report

Anu John, Amitha M Hegde, Preeth Shetty, Shreema Shetty

Keywords : Crown root fracture, Immature teeth, Revascularization

Citation Information : John A, Hegde AM, Shetty P, Shetty S. Revascularization of an Immature Permanent Central Incisor with Complicated Crown Root Fracture: A Case Report. Int J Clin Pediatr Dent 2019; 12 (1):59-63.

DOI: 10.5005/jp-journals-10005-1574

License: CC BY-NC 4.0

Published Online: 00-02-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

The treatment of complicated crown root fracture in children possesses a great challenge to pedodontists. A 10-year-old boy presented with trauma to the permanent maxillary left central incisor. Upon clinical and radiographic examination, revealed mobility of coronal fragment, open apex, and vertical fracture involving enamel dentin and pulp. Instead of the standard root canal treatment protocol, revascularization was performed after stabilizing the coronal fragment. The detachment of the coronal fragment occurred following a fall for the second time after 1 month of placement of mineral trioxide aggregate (MTA) over the blood clot. The coronal seal was intact; hence, the coronal fragment was reattached and the crown was placed. At 12-month follow-up, clinical and radiographic evaluation showed that the tooth was asymptomatic and functional. With increasing scope of clinical facts, patient, and practitioner favorable reception, regenerative techniques may be used as a standard technique in treating complicated crown root fracture in young permanent teeth.


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  1. Dummer PM, Davies J, et al. Automated thermatic condensation of gutta-percha root fillings in teeth with open (immature) apices. J Oral Rehabil 1985 Jul;12(4):323–330. DOI: 10.1111/j.1365-2842.1985. tb01286.x.
  2. Mandel E, Bourguignon-Adelle C. Endodontic retreatment: a rational approach to non-surgical root canal therapy of immature teeth. Endod Dent Traumatol 1996 Oct;12(5):246–253. DOI: 10.1111/j.1600- 9657.1996.tb00523.x.
  3. Mackie IC, Hill FJ. A clinical guide to the endodontic treatment of non-vital immature permanent teeth. Br Dent J 1999 Jan;186(2):54–58. DOI: 10.1038/sj.bdj.4800019.
  4. Allen R, Mackie IC. Management of the immature apex—a clinical guide. Dent Update 2003 Oct;30(8):437–441. DOI: 10.12968/denu.2003.30.8.437.
  5. Wilkinson KL, Beeson TJ, et al. Fracture resistance of stimulated immature teeth filled with resilon, gutta-percha, or composite. J Endod 2007 Apr;33(4):480–483. DOI: 10.1016/j.joen.2006.11.014.
  6. Desai S, Chandler N. The restoration of permanent immature anterior teeth, root filled using MTA: a review. J Dent 2009 Sep;37(9):652–657. DOI: 10.1016/j.jdent.2009.05.026.
  7. Cvek M. A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture. J Endod 1978 Aug;4(8):232–237. DOI: 10.1016/S0099- 2399(78)80153-8.
  8. Nygaard-Ostby B, Hjortdal O. Tissue formation in the root canal following pulp removal. Scand J Dent Res 1971 Apr;79(5):333–349. DOI: 10.1111/j.1600-0722.1971.tb02019.x.
  9. Epelman I, Murray PE, et al. A practitioner survey on options toward regenerative endodontics. J Endod 2009 Sep;35(9):1204–1210. DOI: 10.1016/j.joen.2009.04.059.
  10. Murray PE, Garcia-Godoy F, et al. Regenerative endodontics: a review on current status and a call for action. J Endod 2007 Apr;33(4): 377–390. DOI: 10.1016/j.joen.2006.09.013.
  11. Diangelis AJ, Andreasen JO, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxation of permanent teeth. J Dental Traumatol 2012 Feb;28(1):2–12. DOI: 10.1111/j.1600-9657.2011.01103.x.
  12. Hargreaves K, Law A. Regenerative endodontics. Hargreaves K, Cohen S, ed. Pathways of the pulp, 10th edn. St Louis: Mosby Elsevier, 2011;pp. 602–619.
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