Crown-root fracture without pulp involvement- Treatment Guidelines
Localization of fracture line
- The fracture involves the crown and root of the tooth and is in a horizontal or diagonal plane. A radiographic examination usually only reveals the coronal part of the fracture and not the apical portion
- A cone beam exposure can reveal the whole fracture extension
treatment
Depending on the clinical findings, two treatment scenarios may be considered. Most of these may be deferred to later treatment.
- Fragment removal only
If the fracture involves only a small part of the root and the stable fragment is large enough to allow coronal restoration, remove the mobile fragment.
- Extraction
Extraction is inevitable in very deep
crown-root fractures, the extreme being a vertical fracture. Care must be taken
to prevent trauma to the subjacent tooth bud.
Patient instructions
Soft food for 10-14 days.
Good healing following an injury to the teeth and oral tissues depends, in part,
on good oral hygiene. Brush with a soft brush after every meal and apply
chlorhexidine 0.1 % topically to the affected area with cotton swabs twice a day
for one week. This is beneficial to prevent accumulation of plaque and debris
along with recommending a soft diet.
Parents should be further advised about possible complications that
may occur, like swelling, increased mobility or fistula. Children may not
complain about pain; however, infection may be present and parents should watch
for signs of swelling of the gums and bring the child in for treatment.
Follow-up
Clinical control after 3-4 weeks.