Crown-root fracture with pulp involvement - Treatment 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.