Management of crown fractures with different pulp treatments and Re-attachment technique: case series

Crown fracture is a type of traumatic injury that mostly affects the maxillary incisors. Depending on the involvement of the pulp, crown fracture may occur as complicated or uncomplicated and constitutes 26-76% of dental injuries in the permanent teeth. The effective treatment of crown fractures should aim to gain optimal aesthetics and function by preserving the vitality of the tooth. There have been case reports in the literature regarding pulpotomy and reattachment techniques in traumatized teeth. However, there has been no case series presenting different endodontic treatments performed with different current materials along with the reattachment technique. The aim of the current case series is to present treatment approaches of 3 crown fracture cases with different pulp treatments and re-attachment technique.

In all cases the patients were 8 years old boys. In the first and third cases, complicated crown fractures involved upper central incisors. After endodontic treatment with Cvek pulpotomy, the teeth were restored using Biodentine in case 1 and MTA in case 3. In the second case, uncomplicated crown fracture of the lower central incisor was treated with indirect pulp capping. In all cases, the fractured crown parts were re-attached and the patients were scheduled for recall appointments.

Re-attachment technique offers aesthetic, functional and economic treatment option by long-term preserving the anatomic form, color and surface texture. The evaluation of the pulpal status before the reattachment technique and application of the proper pulpal treatment influences the prognosis of the tooth.