Crown-root fracture with pulp involvement - Treatment Guidelines
The treatment animation above is presently being updated to the 2012 IADT guidelines. The guidelines
shown below are however in accordance with the new set of IADT guidelines.
Localization of fracture line
The fracture involves the crown and root of the tooth and is in a horizontal or diagonal plane. A radiographic examination usually only reveals the coronal part of the fracture and not the apical portion.
Treatment
Depending on the clinical findings, two treatment scenarios may be considered.
- Fragment removal only if the fracture involves only a small part of the root and the stable fragment is large enough to allow coronal restoration.
- Extration in all other instances.
Patient instructions
Soft food for 10-14 days.
Good healing following an injury to the teeth and oral tissues depends, in part,
on good oral hygiene. Brush with a soft brush after every meal. This is beneficial to prevent accumulation of plaque and debris
along with recommending a soft diet.
Parents should be further advised about possible complications that
may occur, like swelling or fistula. Children may not
complain about pain; however, infection may be present and parents should watch
for signs of swelling of the gums and bring the child in for treatment.
Follow-up
In case of fragment removal only: Clinical and radiographic control at 1 year and every year until eruption of the
permanent successor.
In case of tooth extration: Clinical and radiographic control at 1 year and every year until eruption of the permanent successor.