An 11-year-old female patient with a history of falls came to the office complaining of a fractured tooth. Her guardians brought the fragments. On clinical examination a crown fracture was observed on tooth 11 without pulpal exposure (uncomplicated). Radiographic examination revealed incomplete root formation at Nolla stage 9. The fragments were placed in saline solution and then conditioned with phosphoric acid, as well as the remnant. The fragments were then bonded and finished.
The patient's caretaker was advised for long-term clinical and radiographic proservation.
Case conducted by colleague and former student of specialization in endodontics at HPG Brasília, Sinuhe Marinho Saad.
In: Prado et al. Coronoradicular fracture: a multidisciplinary approachRev Odontol UNESP. 2012 Sept-Oct.
A coronoradicular fracture is defined as a fracture involving enamel, dentin and cementum. These fractures can be
classified as complicated, when there is pulpal involvement, and uncomplicated, when this does not occur.
This type of fracture comprises 5% of the traumatic injuries that affect the permanent dentition and 2% of the injuries that occur in the deciduous dentition. The etiological factors most commonly associated with these fractures during childhood are falls; in adolescence, it is related to sports practice and, in adults, to car accidents. Traumas related to violence have also been reported in the literature. The most commonly affected tooth is the maxillary central incisor, whose trauma can cause functional, aesthetic and phonetic problems
.
The proposed treatments for uncomplicated coronoradicular fractures consist of fragment removal associated
with restorative treatment, or fragment removal, gingivectomy and restorative treatment, depending on the case. In cases of complicated fractures, the treatment consists of fragment removal, gingivectomy, endodontic treatment and restorative treatment, or even fragment removal associated with orthodontic extrusion of the apical fragment or surgical extrusion of the same, associated with endodontic and prosthetic treatment.
Uncomplicated crown fracture.
