A conservative approach toward restoration of fractured anterior tooth

Reattachment of Fractured Tooth Fragment by Multidisciplinary Treatment Approach

Dental anterior fractures are common injuries, especially in those who practice extreme sports. This report describes a 25-year-old Bolivian patient who attended our private dental clinic in La Paz, Bolivia after experiencing an accident during downhill mountain biking. An intraoral examination revealed a fracture line on the buccal side in the middle third of the coronal portion of the right central maxillary incisor which extended towards the proximal and lingual sides. Multidisciplinary treatment, including crown lengthening, osteotomy, root canal treatment, fiberglass post insertion, and reattachment of the fracture segment was performed. A follow-up examination at 10 months later revealed that the tooth was completely reestablished both functionally and esthetically and that there was no periapical pathosis or discomfort. This outcome suggests that if a patient seeks a dental consultation soon after a complex crown-root fracture has occurred, and if the broken tooth segment is available, then reattachment offers an economical and simple treatment option which will allow immediate restoration of functionality and esthetic standards. Continued follow-up should form part of such a treatment plan to allow long-term pulp vitality and periodontal health status to be monitored.

Management of Ellis Class III Fracture in Two Maxillary Incisivus

Introduction. Trauma injury in the oral cavity due to collisions can cause tooth fracture. Ellis class III fracture is a fracture of the crown with an open pulp. Teeth with exposed pulp will cause irritation of the pulp resulting in pulp inflammation (pulpitis). One visit pulpectomy and jacket crown with posts were carried out to achieve optimal dental functions. Case report. A 27-year-old male patient came to Dental Hospital of Universitas Gadjah Mada complained about his broken front teeth due to accident three days earlier. The crown of the maxillary right lateral incisor and the maxillary left central incisor with open pulp was seen. The tooth 11 was avulsion, which lost at the location of accident. The diagnosis of 12 and 21 were Ellis class III fracture. Initially an infiltration anaesthesia was done, followed by one visit root canal treatment (RCT). On the second visit, the teeth were asymptomatic, hence the jacket crown preparation and fiber post insertion were performed. On the third visit, a porcelain jacket crown was cemented into teeth 12 and 21. A week later the patient came for recall and no complaints were noted. Conclusion. One visit pulpectomy followed by restoration with porcelain crown and fiber posts can be undertaken to achieve the optimal functions of teeth, namely aesthetic, mastication, phonetics, and protection of supporting tissues function.