Ergonomia em medicina dentaria

258 Dent J (2011) 22(3): 258-262 Braz

S.R. Fidel et al.

ISSN 0103-6440

Clinical Management of a Complicated Crown-Root Fracture: A Case Report
Sandra Rivera FIDEL1 Rivail Antonio Sergio FIDEL-JUNIOR2 Luciana Moura SASSONE1 Cristiana Francescutti MURAD1 Rivail Antonio Sergio FIDEL1
1UERJ

2Veiga

- Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil de Almeida University, Rio de Janeiro, RJ, Brazil

This report describes the clinical procedures involved in the treatment of a complicated crown-root fracture in the maxillary left central incisor with a wide open apex of a 10-year-old male patient, due to fall from his own height. Post-trauma treatment comprised cervical pulpotomy and adhesive tooth fragment reattachment. After 1 year, clinical and radiograph examinations showed pulp necrosis and an associated periapical lesion. Endodontic therapy with calcium hydroxide-base intracanal dressing, root canal filling and orthodontic extrusion were performed. Extrusion was completed within approximately 16 weeks and the tooth was restored with a post-core system and a prosthetic crown. After a 3 years of follow-up, there was no evidence of apical periodontitis and the tooth was satisfactory both esthetically and functionally. Key Words: crown-root fracture, traumatic dental injuries, permanent tooth, orthodontic extrusion.

INTRODUCTION
Traumatic injuries to teeth and their supporting tissues usually occur in young people and damage may vary from enamel fracture to avulsion, with or without pulpal involvement or bone fracture. A crown-root fracture is a type of dental trauma, usually resulting from horizontal impact, which involves enamel, dentin and cementum, occurs below the gingival margin and may be classified as complicated or uncomplicated, depending on whether pulp involvement is present or absent (1,2). Most of these injuries occur in permanent maxillary incisors before complete root formation and cause pulp inflammation or necrosis (1).