Crown-root fracture without 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. Most of these may be deferred to later treatment.
- 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, remove the mobile fragment.
- Extraction
Extraction 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 and apply
chlorhexidine 0.1 % topically to the affected area with cotton swabs twice a day
for one week. 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, increased mobility 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 control after 1 week. Clinical and
radiographic control after 3-4 weeks. Clinical control after 1 year.
In case of tooth extration: Clinical and radiographic control at 1 year and every year until eruption of the permanent successor.