The Management of Crown Fracture of Immature Teeth by MTA and Calcium Hydroxide
Traumatic
injuries to teeth with or without pulpal involvement occur in children and
adolescents. The majority of these injuries occur before root formation is
complete, causing in some cases pulp inflammation and necrosis, with possible
impact on the quality of life of affected individuals. Anterior crown fractures
are favoured by the protruded position of maxillary incisors and their eruptive
pattern. The most susceptible age to dental trauma is between 6 to 12 years .
Complicated crown fractures represent 18-20% of all traumatic injuries topermanent teeth.
The treatment options vary due to tooth maturity, the time
lapse between the accident and the treatment, the severity of pulp exposure,
the presence or absence of haemorrhage, the size of the remaining crown,
periodontal status and occlusal relations . Root formation is
classified in seven stages by Moorrees et al. Vital amputation (pulpotomy) is
the treatment of choice for traumatized immature teeth with pulp exposure. It allows further root development, with apical closure and
strengthening of the root structure. If the pulp vitality of a traumatized
immature tooth is lost, the treatment will be a challenge, especially for pulp
necrosis in teeth with inadequate radicular development due to the fact that an
open apex in permanent tooth takes approximately 3 years to close after tooth
eruption . In the case of pulp necrosis, pulpectomy and root canal therapy
should be preferred. Read more.............
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