Conservative and Aesthetic Emergency Management in Adolescent with Complex Crown-Root Fracture and Simultaneous Oblique Root Fracture in Upper Maxillary Central Incisor: Clinical Outcome after 18 Months Follow-up Period
Emergency treatment of 11- years-old female patient, presenting a complicated crown root fracture, which simultaneously presented oblique root fracture in the maxillary right central incisor. In order to expose the subgingival extension of the fracture, it was necessary to raise a mucoperiosteal flap. In light of pulp exposure, and prior to the repositioning of fragments with adhesive composite resin technique, Cvek pulp therapy was performed . Despite the existence of a 4-5 mm subgingival extension, neither surgical nor orthodontic extrusion of the root fragment was performed due to the presence of intra-alveolar oblique root fracture without displacement. Minimally invasive and conservative clinical management is basic, namely due to the great capacity of pulp healing in young permanent teeth, the absence of displacement between fragments of root fracture, and great capacity of adhesion and tensile strength of current adhesive systems. Clinical and radiographic controls over the first 18 months have shown an excellent pulp response, with some minor periodontal complications in relation to the biological width invasion and an adequate functional and aesthetic result.