Follow-up study of permanent incisors with complicated crown fractures after acute trauma

Complicated fractures occur in 3.5% of acute traumatized incisors. A pulp exposure results in almost all cases in endodontic treatment. The present investigation evaluated the prognosis for the different types of endodontic treatments following complicated crown fractures. Only incisors with an observation period of more than 23 months are included; the material comprises 301 incisors. Pulp capping was successful in 90.5% of the cases. There was a clear tendency for a positive correlation between the stage of the root development and the success rate of the endodontic treatment. In cases with pulpotomy ZnO/eugenol cement or calcium hydroxide was used as amputation material. The pulp reactions following the different treatments are discussed. If calcium hydroxide was used 90% was successful, while in cases with ZnO/eugenol cement as amputation material 8.9% developed necrosis of the pulp and 34.4% showed an undesirable reaction with formation of hard tissue barrier or obliteration. The healing frequency was 83.9% for teeth treated with pulpectomy but there was a clear correlation between the standard of the root filling and the success rate. For all three treatment groups there was a correlation between damage to the supportive tissue and treatment success.