• 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.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.

• The Journal of the Korean dental association
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• v.57 no.11
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• pp.679-688
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• 2019

A 8-year-old patient presented with a crown-root fracture of the maxillary right central incisor with an oblique subgingival fracture line. A multidisciplinary treatment approach including endodontic treatment, surgical extraction and intraalveolar repositioning was used to gain sufficient crown length of the fractured maxillary incisor. The coronally repositioned maxillary right central incisor was stabilized by a resin wire splint. Apexification using MTA was performed. Resin core and direct resin restoration(Cl IV) on fractured teeth was built up. Clinical and radiographic follow-up of the maxillary right central incisor after 36 months showed no signs of root resorption or pathology and acceptable aesthetics and functions were maintained. Surgical extrusion can be considered as a good treatment modality for young patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.5
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• pp.254-259
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• 2019

Objectives: Crown-root fracture and cervical caries in maxillary premolars constitute a challenge in cases of subgingival placement of restoration margins. Surgical extrusion has been practiced successfully in permanent anterior teeth. The aim of the present retrospective study was to assess the clinical outcome of surgical extrusion after orthodontic extrusion in maxillary premolars. Materials and Methods: Twenty-one single, tapered root maxillary premolars with subgingival crown-root fracture or caries were included. Presurgical orthodontic extrusion was performed on all teeth to prevent root resorption. Extent of extrusion and rotation was determined based on crown/root ratio. The postoperative splinting period was 7 to 14 days. Clinical and radiographic examination was performed at an interval of 1, 2, and 3 months. Results: After the mean follow-up of $41.9{\pm}15.2months$, failure was observed as increased mobility in 3 of 21 cases. No significant difference was observed in the outcome of surgical extrusion based on tooth type, age, sex, $180^{\circ}$ rotation, or time for extraction. Furthermore, marginal bone loss was not observed. Conclusion: Surgical extrusion of maxillary premolars can be a possible therapeutic option in cases of subgingival crown-root fracture.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.465-470
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• 2003

Transverse and oblique crown-root fractures constitute a major therapeutic problem, particularly in young dentitions. Because crown-root fracture may involve enamel, dentin, pulp, and periodontal tissues, management of the injuries must be modified accordingly. When the fracture line was located under the alveolar crest. there are several methods for crown-root fractured teeth with pulp exposure, 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 case, the fractured tooth is intentionally extracted atraumatically, and replanted by rotating approximately 180 degree into the original socket and fixing with an orthodontic wire. At the 8-month recall examination, the root still showed normal mobility and there was not observed any inflammatory or replacement root resorption in the periapical radiograph.

• Restorative Dentistry and Endodontics
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• v.35 no.5
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• pp.395-400
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• 2010

The development of adhesive dentistry has allowed that the crown fragment reattachment can be another option in the treatment of crown fracture. However, additional crown lengthening procedure or extrusion of the tooth may be necessary in the treatment of crown root fracture because subgingival fracture line in close proximity to the alveolar bone leads to challenges for restorative procedure and the violation of the biologic width. This case report presents a modified crown fragment reattachment technique of crown root fracture with pulp exposure, which was done without additional crown lengthening procedures. After the endodontic treatment, the patient was treated using a post insertion and the fragment reattachment technique, which made it possible to preserve the space for the biologic width and maintain a dry surgical field for adequate adhesion through the modification of the fractured coronal fragment. Since a coronal fracture was occurred and reattached afterward, it was observed that the coronal fragment was well maintained without the additional loss of periodontal attachment through 2-year follow up.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.4
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• pp.968-974
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• 1996

Intra-alveolar transverse crown & root fx. provokes many problems in treatment. Conventionally, extraction of the injured tooth and its prosthodontic restoration has been the treatment of choice. Though orthodontic extrusion could be an alternative treatment, there would be a situation it's inadequate to apply. Loss of natural tooth would be a psychological damage to the patient, of course. This report describes a replantation method of tooth in case of intra-alveolar transverse crown & root fracture. The fractured tooth was extracted, rotated, then replanted. Fixation and esthetic restoration was done. And then endodontic treatment was followed. Continuing follow-up of its function and endodontic status is required.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.1
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• pp.58-65
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• 2012

The crown-root fracture is defined as a fracture of tooth that contains enamel, dentin and cementum with or without pulp exposure. Generally the fracture lines place obliquely from labial surface, between incisal edge of the crown and marginal gingiva, to palatal surface subgingivally. If the fracture line is located supragingivally, the removal of tooth fragment and supragingival restoration can be performed. In subgingival fracture line, the surgical exposure, orthodontic eruption or surgical eruption can be considered. If the fracture line is too deep to restorate, extraction or decoronation can be selected. In children and adolescents, the extraction should be the last option. Another option to select before extraction is the restoration using fiber-reinforced post and the reattachment of tooth fragment. The fiber-rainforced post enhances the retention and the durability of tooth fragment. The reattachment of crown fragment using resin adhesive system is considered minimal invasive treatment biologically. This case reports the treatment of crown-root fracture using the reattachment of crown fragment and the insertion of fiber-reinforced post.

• 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.

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