One case of complicated crown root fracture of upper anterior teeth managed by multidisciplinary joint approaches

doi:10.7518/hxkq.2024.2023342

Abstract

Abstract:

Complicated crown root fracture is a serious combined fracture of the enamel, dentin, and cementum in dental trauma. The treatment method is complicated. During the procedure, the condition of pulp, periodontal, and tooth body should be thoroughly evaluated, and a multidisciplinary approach combined with sequential treatment is recommended. This case reported the different treatment and repair processes of one case of two affected teeth after complicated crown root fracture of upper anterior teeth, including regrafting of broken crown after flap surgery at the first visit, direct resin repair to remove broken fragments, and pulp treatment and post-crown repair at the second visit. After 18 months of follow-up, the preservation treatment of the affected teeth with complicated crown root fracture was achieved. Therefore, fragment reattachment and post-crown restoration are feasible treatment options for children with complicated crown root fracture.

Key words: complicated crown root fracture, fragment reattachment, deep margin elevation, post-crown restoration, all-ceramic crown

CLC Number:

R788

Zhang Baize, Chen Yujiang, Wang Junhui, Liu Jiajia, Wu Li’an. One case of complicated crown root fracture of upper anterior teeth managed by multidisciplinary joint approaches[J]. West China Journal of Stomatology, 2024, 42(2): 249-255.

Figures/Tables 5

References 28

1	Castro JC, Poi WR, Manfrin TM, et al. Analysis of the crown fractures and crown-root fractures due to dental trauma assisted by the Integrated Clinic from 1992 to 2002[J]. Dent Traumatol, 2005, 21(3): 121-126.
2	Huang C, Yang Y, Wang Z, et al. A retrospective study of emergent traumatic dental injuries in permanent teeth in Xi’an, China[J]. Medicine (Baltimore), 2022, 101(52): e32588.
3	刘佳佳, 王小竞. 年轻恒牙复杂冠折及冠根折的诊疗策略[J]. 中国实用口腔科杂志, 2022, 15(4): 405-410.
	Liu JJ, Wang XJ. Diagnosis and treatment strategies of complicated crown fracture and crown-root fracture of young permanent teeth[J]. Chin J Pract Stomatol, 2022, 15(4): 405-410.
4	Chandra RV, Savitharani B, Reddy AA. Comparing the outcomes of incisions made by colorado microdissection needle, electrosurgery tip, and surgical blade during periodontal surgery: a randomized controlled trial[J]. J Indian Soc Periodontol, 2016, 20(6): 616-622.
5	Wang C, Jia XT, Zhen M, et al. Success rate of fractured teeth receiving modified crown lengthening surgeryand restorations[J]. BMC Oral Health, 2022, 22(1): 99.
6	Radwanski M, Caporossi C, Lukomska-Szymanska M, et al. Complicated crown fracture of permanent incisors: a conservative treatment case report and a narrative review[J]. Bioengineering (Basel), 2022, 9(9): 481.
7	Villat C, Machtou P, Naulin-Ifi C. Multidisciplinary approach to the immediate esthetic repair and long-term treatment of an oblique crown-root fracture[J]. Dent Traumatol, 2004, 20(1): 56-60.
8	Cavalleri G, Zerman N. Traumatic crown fractures in permanent incisors with immature roots: a follow-up study[J]. Endod Dent Traumatol, 1995, 11(6): 294-296.
9	Soliman S, Lang LM, Hahn B, et al. Long-term outcome of adhesive fragment reattachment in crown-root fractured teeth[J]. Dent Traumatol, 2020, 36(4): 417-426.
10	Lakshmaiah D, Sr V, Ilango S, et al. Management of complex crown fractures: a case series[J]. Cureus, 2023, 15(4): e37907.
11	Bissinger R, Müller DD, Hickel R, et al. Survival analysis of adhesive reattachments in permanent teeth with crown fractures after dental trauma[J]. Dent Traumatol, 2021, 37(2): 208-214.
12	房志秀, 赵磊, 张新新. 原位断端再接技术在儿童年轻恒前牙复杂冠根折中的应用[J]. 系统医学, 2023, 8(5): 162-165, 170.
	Fang ZX, Zhao L, Zhang XX. Application of in situ stump rejoining technique in complex crown root compromise of young permanent anterior teeth in children[J].Systems Med, 2023, 8(5): 162-165, 170.
13	薛亮, 丁谦文, 张昕. 斜行复杂冠根折保存断冠序列治疗的临床疗效评价[J]. 北京口腔医学, 2018, 26(4): 216-219.
	Xue L, Ding QW, Zhang X. Clinical evaluation of sequential therapy for complicated oblique crown-root fractures[J]. Beijing J Stomatol, 2018, 26(4): 216-219.
14	Castelo-Baz P, Argibay-Lorenzo O, Muñoz F, et al. Periodontal response to a tricalcium silicate material or resin composite placed in close contact to the supracrestal tissue attachment: a histomorphometric comparative study[J]. Clin Oral Investig, 2021, 25(10): 5743-5753.
15	Juloski J, Köken S, Ferrari M. Cervical margin relocation in indirect adhesive restorations: a literature review[J]. J Prosthodont Res, 2018, 62(3): 273-280.
16	Dietschi D, Spreafico R. Evidence-based concepts and procedures for bonded inlays and onlays. PartⅠ. Historical perspectives and clinical rationale for a biosubstitutive approach[J]. Int J Esthet Dent, 2015, 10(2): 210-227.
17	Dietschi D, Spreafico R. Evidence-based concepts and procedures for bonded inlays and onlays. Part Ⅲ. A case series with long-term clinical results and follow-up[J]. Int J Esthet Dent, 2019, 14(2): 118-133.
18	Jepsen S, Caton JG, Albandar JM, et al. Periodontal ma-nifestations of systemic diseases and developmental and acquired conditions: consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Pe-riodontal and Peri-Implant Diseases and Conditions[J]. J Clin Periodontol, 2018, 45(): S219-S229.
19	孟秀萍, 侯建华, 李怡然, 等. 龈壁提升术材料选择及边缘设计的研究进展[J]. 国际口腔医学杂志, 2021, 48(3): 280-286.
	Meng XP, Hou JH, Li YR, et al. Research progress on the selection and design of base materials in deep margin elevation[J]. Int J Stomatol, 2021, 48(3): 280-286.
20	Da Silva D, Ceballos L, Fuentes MV. Influence of the adhesive strategy in the sealing ability of resin composi-te inlays after deep margin elevation[J]. J Clin Exp Dent, 2021, 13(9): e886-e893.
21	Alahmari NM, Adawi HA, Moaleem MMA, et al. Effects of the cervical marginal relocation technique on the marginal adaptation of lithium disilicate CAD/CAM ceramic crowns on premolars[J]. J Contemp Dent Pract, 2021, 22(8): 900-906.
22	Beit P, Konstantonis D, Papagiannis A, et al. Vertical skeletal changes after extraction and non-extraction treatment in matched classⅠpatients identified by a discriminant analysis: cephalometric appraisal and Procrustes superimposition[J]. Prog Orthod, 2017, 18(1): 10-44.
23	Meyer AH, Woods MG, Manton DJ. Maxillary arch wid-th and buccal corridor changes with orthodontic treatment. Part 1: differences between premolar extraction and nonextraction treatment outcomes[J]. Am J Orthod Dentofacial Orthop, 2014, 145(2): 207-216.
24	Sulaiman TA, Abdulmajeed AA, Delgado A, et al. Fracture rate of 188 695 lithium disilicate and zirconia cera-mic restorations after up to 7.5 years of clinical service: a dental laboratory survey[J]. J Prosthet Dent, 2020, 123(6): 807-810.
25	林泓磊, 李麒, 于皓, 等. 不同颜色与厚度的2种玻璃陶瓷修复体对光固化灯透射光学性能的影响[J]. 上海口腔医学, 2020, 29(1): 13-18.
	Lin HL, Li Q, Yu H, et al. Optical properties of LED light curing unit before and after transmitting different colors and thickness of two kinds of glass ceramics[J]. Shanghai J Stomatol, 2020, 29(1): 13-18.
26	丁婕, 李娟, 王思明. 铸瓷贴面用于前牙美容修复效果的影响因素分析[J]. 湖南师范大学学报(医学版), 2020, 17(5): 129-131.
	Ding J, Li J, Wang SM. Influencing factors of cast porcelain veneers cosmetic restoration of anterior teeth[J].J Hunan Normal Univ (Med Sci), 2020, 17(5): 129-131.
27	Jurema ALB, Filgueiras AT, Santos KA, et al. Effect of intraradicular fiber post on the fracture resistance of en-dodontically treated and restored anterior teeth: a systematic review and meta-analysis[J]. J Prosthet Dent, 2022, 128(1): 13-24.
28	陈志宇, 李雅, 李绍萍, 等. 一体化纤维桩核结合原全冠修复折断前牙的3年临床观察[J]. 北京口腔医学, 2022, 30(3): 195-198.
	Chen ZY, Li Y, Li SP, et al. Restoration of fractured anterior teeth crown by one-piece fiber post-and-core and the original crown:a 3 years of retrospective evaluation[J]. Beijing J Stomatol, 2022, 30(3): 195-198.

[1]	Li Sinuo, Zhang Luyao, Liang Shanshan, Liu Yuqiang, Xing Wenzhong. Effect of ceramic type and thickness on the masking ability of chairside machinable all-ceramic crowns [J]. West China Journal of Stomatology, 2024, 42(1): 56-61.
[2]	Zhan Lilin, Zeng Liwei, Chen Ping, Liao Lan, Li Shiyue, Liu Renying. Study on the effect of different impression methods on the marginal fit of all-ceramic crowns [J]. West China Journal of Stomatology, 2015, 33(4): 401-404.
[3]	Zhong Qian, Zhou Guoxing, Guang Hanbing, Dai Wenyong, Qiu Jing, Wang Guoping, Zhu Zhijun, Tang Chunbo. . Clinical evaluation on aesthetic effect of custom pressable metal ceramic abutment for dental implant restoration in anterior zone [J]. West China Journal of Stomatology, 2013, 31(4): 429-431,433.
[4]	Hu Jian1，Zhang Feimin1, Dai Ning2, Li Shuanggao2, Gu Weiping1, Ma Junchi1.. Finite element stress analysis of all-ceramic crown of the upper central incisor in differential thickness [J]. West China Journal of Stomatology, 2012, 30(4): 356-359.
[5]	TAN Fa-bing1, WANG Lu1, FU Gang1, WU Shu-hong2, JIN Ping2. An experimental study on the effect of different optical impression methods on marginal and internal fit of all-ceramic crowns [J]. West China Journal of Stomatology, 2010, 28(01): 29-33.