Travmaya Bağlı Komplike Kron Kırığı Olan Genç Daimi Bir Dişte Vital Pulpa Tedavisinin Başarısı

Abstract

Amaç: Komplike kron kırıkları; mine, dentin ve pulpa dokularını içeren travmatik dental yaralanmalardır. Genç daimi dişlerde pulpa canlılığının korunması, kök gelişiminin devam edebilmesi ve dişin fonksiyonunun sürdürülebilmesi açısından önemlidir. Bu olgu sunumunun amacı, komplike kron kırığı bulunan genç daimi maksiller santral kesici dişe uygulanan parsiyel pulpotomi ve kırık parça reataşmanının iki yıllık klinik ve radyografik sonuçlarını sunmaktır. Olgu Sunumu: Sekiz yaşındaki sağlıklı erkek hasta, okulda düşme sonucu maksiller santral kesici dişinde meydana gelen komplike kron kırığı nedeniyle kliniğe başvurdu. Kırık parça süt içerisinde saklanarak kliniğe getirildi. Etkilenen diş soğuk pulpa vitalite testine pozitif yanıt verirken kök kırığı veya dentoalveolar yaralanma saptanmadı. Parsiyel pulpotomi uygulanarak kalan vital pulpa dokusu üzerine mineral trioksit agregat yerleştirildi. Pulpa iyileşmesi ve vitalitenin devam ettiği doğrulandıktan sonra kırık parça adeziv olarak yeniden yapıştırıldı. İki yıl boyunca düzenli klinik ve radyografik takipler gerçekleştirildi. Takip süresince diş vital ve asemptomatik kaldı; kök gelişiminin devam ettiği ve periapikal patoloji veya kök rezorpsiyonu bulunmadığı gözlendi. Sonuç: Mineral trioksit agregat kullanılarak gerçekleştirilen parsiyel pulpotomi ve ardından kırık parçanın adeziv olarak yeniden yapıştırılması olumlu klinik ve radyografik sonuçlar sağlamıştır. Pulpa canlılığının korunması, iki yıllık takip süresince kök gelişiminin devam etmesine olanak sağlamıştır.

Keywords

• Diş Kırıkları
• Pulpotomi
• Pulpa
• Dental Travma

The Success of Vital Pulp Therapy in a Young Permanent Tooth with a Complicated Crown Fracture Due to Trauma

Abstract

Aim: Complicated crown fractures are traumatic dental injuries involving the enamel, dentin, and pulp. In young permanent teeth, preservation of pulp vitality is essential to allow continued root development and maintain the tooth in function. This case report aimed to present the two-year clinical and radiographic outcomes of partial pulpotomy and fractured fragment reattachment in a young permanent maxillary central incisor with a complicated crown fracture. Case Report: An 8-year-old healthy boy presented with a complicated crown fracture of the maxillary central incisor following a fall at school. The fractured fragment had been stored in milk and brought to the clinic. The affected tooth showed a positive response to the cold pulp vitality test, with no evidence of root fracture or dentoalveolar injury. Partial pulpotomy was performed, and mineral trioxide aggregate was placed over the remaining vital pulp tissue. After pulpal healing and maintenance of vitality were confirmed, the fractured fragment was adhesively reattached. Regular clinical and radiographic follow-up examinations were performed for two years. The tooth remained vital and asymptomatic, with continued root development and no evidence of periapical pathology or root resorption. Conclusion: Partial pulpotomy with mineral trioxide aggregate followed by adhesive reattachment of the fractured fragment resulted in favorable clinical and radiographic outcomes. Preservation of pulp vitality enabled continued root development during the two-year follow-up period.

Keywords

• Tooth Fractures
• Pulpotomy
• Dental Pulp
• Dental Trauma

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