• Journal of the korean academy of Pediatric Dentistry
• /
• v.30 no.3
• /
• pp.385-390
• /
• 2003

Traumatic injuries in the young permanent dentition are common, but root fractures, defined as fractures involving dentin, cementum and pulp, are relatively uncommon. Appropriate management of root fracture involves repositioning the coronal portion of the tooth fragment and firm immobilization with a splint for 2 to 3 month. Root canal treatment should not be initiated until the sign of necrosis or resorption are apparent because in most cases, the apical fragments maintain their vitality. The following case report describes a patient with root fractures injured three times over the period of 7 years. The results, clinically and radiographically, were acceptable, but long term periodic evaluation is required.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.1
• /
• pp.92-97
• /
• 2004

Traumatic injuries in the young peranent dentition are common, but root fractures, defined as fractures in volving dentin, cementum and pulp, are relatively uncommon. Case 1 is a 9-year-old boy who had a horizontal root fracture of his maxillary right central incisor in the apical third. Root canal therapy was performed in coronal segment and calcium hydroxide therapy was initiated. Six months after treatment, a periapical radiograph showed calcific tissue formation and normal root development. 1 year and 3 months later, the canal was permanently obturated with gutta-percha. Case 2 is a 7-year-old girl who had a vertical root fracture of her maxillary right central incisor. Fractured tooth was intentionally extracted atraumatically, and then the separated fragments are bonded with resin cement. the restored tooth was replanted into the original socket. Recalls up to 8 months showed normal mobility and no periapical pathosis. In these cases, we performed conservative treatment. Clinical and radiographic examination showed no pathosis or abnormality of the teeth and periodontal tissue.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.34 no.3
• /
• pp.454-460
• /
• 2007

Traumatic dental injuries in childhood and adolescent occurred more frequently than in adult. The time between the accident and the treatment is one of the most critical factors to prognosis, and because of the limited time available to examine and treat patients with traumatic dental injuries, if not treat appropriately, the result would be critical for the patient. In the previous studies, the prevalence and incidence of traumatic injuries were the most frequent at the age of 8 to 10 years, the majority of dental injuries involve the anterior teeth, especially the maxillary incisors, and males were more prevalent than females in an approximated proportion of 2:1. As the mean age of complete root formation is 10 years old, the maxillary permanent incisor involved in the most affected age group is usually immature, and the possibility of pulpal healing through excellent revascularization exists, more positive prognosis for pulp vitality would be expected. These are treatment cases of the immature maxillary permanent central incisor involved in the traumatic injury, and reports for progress and results of preserving the pulp vitality through the conservative treatment instead of the conventional endodontic root therapy.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.27 no.2
• /
• pp.344-350
• /
• 2000

Incidence of crown-root fracture due to traumatic injury, have been reported 3% in the permanent dentiton, 2% in the deciduous dentition. There are two treatment methods for crown-root fractured teeth with pulp exposure, when the fracture line was located under the alveolar crest. One way is the extrusion by orthodontic force the other way is intra-alveolar transplantation which occlusally repositioning of apical fragment in the alveolar socket. Since intra-alveolar transplantation has introduced in 1970s, it was practiced as alternative to orthodontic extrusion. As the result, this method may thoughted that had a good prognosis. As a result of trauma, completely crown-root fracture was occured in the maxillary right central incisor in this case. We couldn't reposition the deepest fracture line above the alveolar crest by the conventional surgical extrusion, because apical fragment was too short. Thus, after extraction of apical fragment, we repositioned it to the socket following demineralized freezed dried bone graft, which possible to support the apical fragment. At the 15-month recall examination, the root still showed normal mobility and there was not observed any in flammatory or replacement root resorption in the periapical radiograph.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.43 no.2
• /
• pp.200-206
• /
• 2016

Root fracture is defined as a fracture involving the dentin, cementum, and pulp. Most fractures occur in the maxillary anterior teeth between the ages of 11 and 20 years old. The treatment for root fracture in permanent teeth involves the reduction and fixation of the displaced coronal segment. When signs of pulp necrosis or inflammatory root resorption are present, root canal therapy should be performed. Since most apical fragments maintain pulp vitality, root canal therapy is typically limited to coronal fragments. However, it's too difficult to achieve a proper apical stop on coronal fragment. Intentional replantation involves performing root apex treatment outside the mouth after intentional extraction of the tooth in a controlled environment and then replanting it. The objective is 'perfect' root canal therapy. Intentional replantation may be used in cases of failed typical root canal therapy, problematic endodontic retreatment due to the existing restoration or a calcified root canal, and when apical surgery is contraindicated because of a lack of reasonable approaches. In this case, intentional replantation was carried out to treat a horizontal root fracture in a maxillary central incisor with a calcified root canal due to previous trauma. We achieved a clinically and functionally satisfactory result.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.2
• /
• pp.267-272
• /
• 2004

This case report describes an uncommon treatment method for crown-root fractured incisor with immature root. A 7-year-old girl was referred for treatment of crown-root fractured maxillary central incisor. The fracture line extended to 1/2 of the total tooth length with incomplete root formation. The prognosis of crown-root fracture is usually poor and extraction is usually undertaken. But, in the mixed dentition, extraction of maxillary permanent incisor results in many complications, such as resorption of alveolar bone, poor esthetics, pronunciation and mastication. Conservative therapy in the permanent dentition comprises of few treatment modalities; supragingival restoration, gingivectomy, orthodontic extraction of apical fragment, surgical extrusion of apical fragment with or without rotational replantation. However, in this case, these indications are not applicable, so intentional replantation with adhesive resin system is the treatment of choice. The tooth was followed-up for 12 months. Currently, there are no symptoms. Since this modality adopts the respective advantages of both intentional replantation and adhesive treatment, it might be the treatment of choice in cases of vertical crown-root fracture.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.35 no.2
• /
• pp.305-312
• /
• 2008

Crown-root fractures occur throughout both crown and root, and are defined as fractures involving enamel, dentin and cementum. The fractures may be grouped according to pulpal involvement into complicated and uncomplicated one. Crown-root fractures often occur on maxillary anterior teeth and comprise 5% of injuries affecting the permanent dentition and 2% in the primary dentition. To restore crown-root fractured tooth, biologic width must be maintained. For maintaining biologic width, such methods as gingivectomy following osteoplasty or orthodontic extrusion or surgical extrusion are available. Surgical extrusion is a method that extracts the tooth and replants the fractured tooth supragingivally. It is indicated when the length of the crown fragment is less than half the length of the clinical root. In these cases, root canal treatment and crown restoration using light-cured composite resin were performed after surgical extrusion. In following periodic examinations, favorable outcome was observed.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.40 no.1
• /
• pp.24-30
• /
• 2024

Complicated crown fractures of maxillary anterior teeth caused by trauma in adolescence can cause functional and aesthetic problems. For crown fractures with pulp exposure, various restorative methods can be considered depending on the amount of remaining tooth structure. Direct resin restorations are the most traditional and effective method, but they are likely to discolor and break over time. Fixed prosthesis have a high possibility of re-restoration due to marginal disharmony due to tooth movement during the growth period, and restorations using post which are mainly performed for extensive crown fractures increase the risk of root perforation and root fracture. However, endocrown is an integrated structure that gains retention force from the pulp space, enabling effective reconstruction from a biomechanical perspective and providing advantages in restoring function and aesthetics. Therefore, endocrown can be considered as a restoration method for complicated crown fractures caused by trauma in adolescence.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.36 no.1
• /
• pp.48-54
• /
• 2020

In the case of crown-root fracture due to traumatic injury in anterior tooth and the fracture margin is located subgingivally, forced eruption has been proposed for the reconstruction of deficient bone and soft tissue. Forced eruption is one of the easiest orthodontic approaches that can have an acceptable outcome and prognosis, and has a low incidence of relapse. However, using heavy forces or very fast movements can also cause tissue damage or ankylosis. The following case reports present forced eruption as treatment option of crown fracture in maxillary anterior teeth.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.40 no.2
• /
• pp.127-132
• /
• 2013

Traumatic injuries to immature permanent teeth are common and the results can be destructive. Although Hertwig's epithelial root sheath is usually sensitive to trauma, it may resist damage from trauma thereby retaining its vitality and continuing to calcify a root under favorable conditions. This case report describes two cases of trauma to immature permanent incisors. The first case presents an avulsed maxillary central incisor which has been replanted. The other case shows completely avulsed mandibular central incisors which have not been replanted. However, both cases subsequently show continued growing roots separated from the main roots. This report highlights the ability of the immature pulp tissue to continue to form dentin and the robustness of Hertwig's epithelial root sheath to initiate root development despite a traumatic injury.