• The Korean Journal of Oral and Maxillofacial Pathology
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• v.42 no.5
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• pp.153-158
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• 2018

Complicated crown-root fractures are considered rare occurrences in young permanent dentition; however, they often present complicated and unpredictable treatment options. The most common treatment option for crown-root fractured teeth is reattachment of fractured segment, but if it is thought impossible to maintain, it should be extracted. However, when unfavorable crown-root fracture occurs in the adolescents, extraction of fractured teeth is expected to be poor due to excessive resorption of alveolar and prosthetic replacement cannot be performed immediately, various treatment options should be considered. This report suggests root submergence in the complex crown-root fracture in growing patients is performed and the functional and aesthetic results including preservation of the alveolar bone are obtained.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.1
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• pp.60-69
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• 2016

Complicated crown-root fracture of permanent incisors cause esthetic, functional, and psychological problems to patients. Therefore, treatment is important and multidisciplinary treatment is required. This case report describes the clinical procedures involved in the treatment of trauma-induced complicated crown-root fractures in the maxillary incisor of two young patients. Conventional root canal treatment and apexification were performed in each patient. To expose the fracture margins to the supragingival level and to reestablish the biologic width, orthodontic extrusions with fixed appliances were performed followed by a retention period. During the retention period, fiber-optic posts and cores were built up and provisional crowns were placed. Finally, ceramic crowns manufactured using a computer-aided design/computer-aided manufacturing (CAD/CAM) system were placed. In both patients, the teeth presented satisfactory functional and esthetic outcomes without relapse. The periodontal tissues were healthy.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.256-261
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• 2000

Trauma to the tooth is the most common accidents in pediatric dentistry and tooth fracture occurs frequently. Fracture is classified into crown fracture, root fracture, and crown-root fracture which involves both. Also, it is classified into simple or complicated fracture depending on whether the pulp is exposed or not. When the fracture is extended down to the subgingival level following the long axis of the root, or when more than 1/3 of the root is involved, extraction is the primary treatment. But alternative treatment such as extruding the root fragment with orthodontic force and restoring it, or intentionally extracting the tooth and replanting it to a position which it can be restored. This is a case report on intentional replantation of a traumatized maxillary central incisor with crown-root fracture of a patient with mixed dentition. The teeth was extracted and immediate endodontic treatment, retrograde filling and resin restoration were carried out.

• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.1
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• pp.24-30
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• 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 the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.324-332
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• 2008

Traumatic crown fracture in mixed dentition or early permanent dentition is relatively common. Crown fracture is classified into simple or complicated crown fracture by the presence of pulp exposure. The condition of pulp must be considered in treatment of crown fractures with pulp exposure. Treatment of immature crown-fractured incisor with pulp exposure is more complex because of its incomplete root formation. Pulp capping, partial pulpotomy, cervical pulpotomy can be used for continuous root development in immature crown-fractured incisor with pulp exposure. The success rate of partial pulpotomy is very high and there are several advantages of partial pulpotomy because the cell-rich coronal pulp tissue is preserved. This paper reports 2 cases of crown-fractured permanent incisors with pulp exposure that had been treated by partial pulpotomy successfully.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.3
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• pp.243-251
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• 2008

A subgingival crown-root fracture presents a restorative problem to the clinician because restoration is complicated by the need to maintain the sound tooth structures. Forced eruption offers a method of treatment of teeth fractured close to the alveolar crest. Extrusion of such teeth allows elevating the fracture line above the epitherial attachment and so the proper finishing margins can be prepared. The purpose of this case is to report successful tooth restoration using forced eruption in case of crown-root fractures.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.288-292
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• 2009

A crown-root fracture is defined as a fracture involving enamel, dentin, and cementum. The fractures may be grouped according to pulpal involvement into uncomplicated and complicated. Generally a vertically crown-root fractured tooth must be extracted. However, it should be mentioned that the cases have been reported where bonding of the coronal fragment has led to consolidation of the intraalveolar part of the fracture. Definitive conservative therapy comprises one of four treatment alternatives; fragment removal only, fragment removal with gingivectomy, orthodontic extrusion of apical fragment, and surgical extrusion of apical fragment. The choice is primarily determined by the exact information on the site and the type of fracture, but the cost and the complexity of treatment can also be decisional factors. On the other hand, intentional replantation of the teeth with vertical root facture reconstructed with resin bonding has emerged as a new promising method in recent years. This case presents an intentional replantation of the crown-root fractured maxillary central incisor reconstructed with resin bonding. However, an obvious increase of radiolucency was observed after 4 months and the tooth was re-fractured after 16 months.

• Restorative Dentistry and Endodontics
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• v.41 no.3
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• pp.210-217
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• 2016

Exposing sound structure of a subgingivally fractured tooth using orthodontic extrusion is considered to be a conservative way to re-establish biologic width without sacrificing esthetics or jeopardizing periodontal support of neighboring teeth. When a misaligned tooth is traumatically involved, a more comprehensive approach combining tooth extrusion and re-alignment may be necessary for a successful restorative outcome. This case report describes a successful esthetic management of a patient with complicated crown-root fracture on the maxillary right central incisor and pre-existing malocclusion in the maxillary anterior region. Forced eruption along with re-alignment of teeth by orthodontic movement seems to allow re-positioning of the fracture line to a favorable position and correction of crowding, providing a better esthetic result.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.4
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• pp.521-527
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• 2018

In dental trauma, reattachment of the original tooth fragment improves the reproduction of original tooth shape, texture, color, and radiolucency; thus, it provides good aesthetics. A 9-year-old boy was referred due to complicated crown-root fracture of the maxillary right central incisor. Although it had poor prognosis due to severe coronal damage and subcrestal fracture, reattachment of the tooth fragment was chosen due to the patient's age. One-visit apexification with mineral trioxide aggregate (MTA) was performed, followed by osteotomy and reattachment of the tooth fragment with post placement. Regular observation revealed no clinical signs or symptoms and no radiologic complications.

• Restorative Dentistry and Endodontics
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• v.38 no.3
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• pp.178-181
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• 2013

Traumatic injuries to an immature permanent tooth may result in cessation of dentin deposition and root maturation. Endodontic treatment is often complicated in premature tooth with an uncertain prognosis. This article describes successful treatment of two traumatized maxillary central incisors with complicated crown fracture three months after trauma. The radiographic examination showed immature roots in maxillary central incisors of a 9-year-old boy with a radiolucent lesion adjacent to the right central incisor. Apexogenesis was performed for the left central incisor and revascularization treatment was considered for the right one. In 18-month clinical and radiographic follow-up both teeth were asymptomatic, roots continued to develop, and periapical radiolucency of the right central incisor healed. Considering the root development of these contralateral teeth it can be concluded that revascularization is an appropriate treatment method in immature necrotic teeth.