A Conservative Treatment of A Tooth with Complicated Crown-Root Fracture: Relative Success

Year 2020, Volume: 2 Issue: 1, 35 - 39, 28.08.2020

Şeref Nur Mutlu , Makbule Bilge Akbulut , Ayçe Ünverdi Eldeniz

Abstract

Dental traumatic injuries are highly prevalent among children and adolescents. Crown-root fractures of anterior teeth present
difficulties for restoration. This case report describes the treatment of a complicated crown-root fracture of maxillary right
lateral incisor with extensive loss of tooth structure and uncomplicated crown fracture of maxillary right central incisor in a
young adult. The 15-year-old male patient was presented to Endodontic clinic with post-traumatic injury. After the mobile
crown-root fragment of lateral incisor was removed, root canal therapy was performed in two visits. Calcium hydroxide was
used as an intra-canal dressing. Root canal filling, glass fiber post cementation and adhesive tooth fragment reattachment were
performed. Central incisor was restored with composite restoration. Early stage success was achieved with the observance of
good functional and aesthetic outcomes. However the patient did not attend follow-up visits and returned after 14 months with
secondary trauma which resulted fracture of the reattached part and minor fractures extending to middle root so the tooth was
extracted. As it is crucial to retain the tooth to maintain space and to protect alveolar bone height, clinicians should always
consider trying reattachment of tooth fragments. The case presented here is sufficient and effective in postponing fixed prosthetic restorations or implant treatments.

Keywords

Complicated crown-root fracture, Glass fiber post, Reattachment, Traumatic injury

Komplike Kron-Kök Kırıklı Bir Dişin Konservatif Tedavisi: Göreceli Başarı

Abstract

Travmatik diş yaralanmaları çocuklar ve ergenler arasında oldukça yaygındır. Ön dişlerdeki kron-kök kırıkları restorasyon
açısından zorluk teşkil etmektedir. Bu olgu sunumu, genç yetişkin bir hastada maksiller sağ lateral kesici dişin aşırı madde
kaybıyla sonuçlanan komplike kron-kök kırığı tedavisini ve maksiller sağ santral kesici dişteki komplike olmayan kron kırığının
tedavisini açıklamaktadır. 15 yaşında erkek hasta travma sonrası yaralanma ile Endodonti kliniğine başvurdu. Lateral kesici
dişin mobil olan kron-kök parçası çıkarıldıktan sonra kök kanal tedavisi iki seansta tamamlandı. Kanal içi medikament olarak
kalsiyum hidroksit kullanıldı. Kök kanal dolgusu, cam fiber post simantasyonu ve kırık parçanın adeziv reataçmanı yapıldı.
Santral kesici diş kompozit ile restore edildi. İyi bir fonksiyon ve estetik sonuçların gözlenmesi ile erken aşamada başarı elde
edildi. Ancak, hasta kontrol randevularına gelmedi ve 14 ay sonra, yeniden yapıştırılan parçanın kırılması ve kökün ortasına
kadar uzanan minör kırıkların oluşmasıyla sonuçlanan ikinci bir travma ile geri geldi, bu yüzden hastanın dişi, çekildi. Alveoler
kemik yüksekliğini korumak için dişi ağızda tutmak çok önemli olduğundan, klinisyenler her zaman kırık diş parçalarının reataçmanını bir tedavi seçeneği olarak düşünmelidir. Burada sunulan olguda uygulanan tedavi sabit protez restorasyonlarının
veya implant tedavilerinin ertelenmesinde yeterli ve etkilidir

Keywords

komplike kron-kök kırığı, cam fiber post, reataçman, travmatik yaralanma

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