Follow-up study of permanent incisors with enamel-dentin fractures after acute trauma

The present investigation evaluated the prognosis for vitality after an acute trauma in 3144 permanent incisors with enamel-dentin fracture as the only damage and in 923 incisors with enamel-dentin fracture combined with other symptoms on the damaged tooth. The teeth were examined at regular intervals. The observation time was more than 2 years in the case of 78.9% of the material. Pulpal necrosis developed in 250 teeth (6.1%). Pulp death occurred in 3.2% of teeth with enamel-dentin fracture as the only damage. The combination of enamel-dentin fracture and concussion resulted in pulpal necrosis in 5.8% and cases involving both concussion and mobility showed pulpal necrosis in 30.1% of teeth. A registration of the enamel-dentin fracture based on the extent of dentin exposure was undertaken. The relationship between extent of dentin exposure and pulpal necrosis as well as influence of treatment on pulpal necrosis was clearly illustrated. It is concluded that information on damage to the mineralized tissue without details of damage occurring at the same time to supportive tissue is of doubtful value in assessing the prognosis.