Dental and Medical Problems
2018, vol. 55, nr 1, January-March, p. 91–98
doi: 10.17219/dmp/83744
Publication type: clinical case
Language: English
Vital root submergence of immature permanent incisors after complicated crown-root fracture followed by orthodontic space maintenance: A presentation of two cases
Pozostawienie „zatopionego” korzenia stałych siekaczy z niezakończonym rozwojem po ciężkim złamaniu koronowo-korzeniowym w celu ortodontycznego zachowania miejsca w łuku – opis dwóch przypadków
1 Department of Orthodontics, Medical University of Lodz, Poland
2 Department of Pediatric Dentistry, Medical University of Lodz, Poland
Abstract
Complicated crown-root fractures are considered rare occurrences in young permanent dentition; however, they pose a particularly difficult clinical challenge, especially when the traumatized tooth is immature. Two cases of complicated crown-root fractures of immature incisors are presented. In both cases, vital root submergence with no treatment to the exposed pulp was introduced as a stage in a complex treatment plan with the primary goal of preserving the shape of the alveolar ridge in the traumatized area until the root was completely formed or facial growth was finished. No inflammatory symptoms were detected either radiographically or clinically during the 15- and 16-month follow-up periods. In the chosen clinical cases, vital root submergence followed by orthodontic space maintenance can be beneficial to young patients if other treatment options are limited by the depth of the crown-root fracture or if the patient suffers from high dental fear and presents a particularly low level of compliance.
Key words
dental trauma, crown-root fracture, vital root submergence
Słowa kluczowe
uraz zęba, złamanie koronowo-korzeniowe, pozostawienie zatopionego korzenia
References (22)
- Andreasen JO, Andreasen FM, Andersson L. Textbook and colour atlas of traumatic injuries to the teeth. 4th ed. Oxford, England: Blackwell Munksgaard; 2007:314–336.
- Andreasen JO. Etiology and pathogenesis of traumatic dental injuries. A clinical study of 1298 cases. Scand J Dent Res. 1970;78:329–342.
- Naudi AB, Fung DE. Tooth fragment reattachment in multiple complicated permanent incisor crown-root fractures: A report of two cases. Dent Traumatol. 2008;24:248–252.
- Araujo MG, Lindhe J. Dimensional ridge alterations following tooth extraction: An experimental study in the dog. J Clin Periodontol. 2005;32:212–218.
- Araujo MG, Lindhe J. Ridge alterations following tooth extraction with and without flap elevation: An experimental study in the dog. Clin Oral Implants Res. 2009;20:545–549.
- Pinho MN, Roriz VL, Novaes AB, et al. Titanium membranes in prevention of alveolar collapse after tooth extraction. Implant Dent. 2006;15:53–61.
- Darby I, Chen ST, Buser D. Ridge preservation techniques for implant therapy. Int J Oral Maxillofac Implants. 2009;24(Suppl):260–271.
- Jung RE, Philipp A, Annen BM. Radiographic evaluation of different techniques for ridge preservation after tooth extraction: A randomized controlled clinical trial. J Clin Periodontol. 2013;40:90–98.
- Fariniuk LF, Ferreira EL, Soresini GC, Cavali AE, Baratto Filho F. Intentional replantation with 180 degree rotation of a crown-root fracture: A case report. Dent Traumatol. 2003;19:321–325.
- Díaz SC, Ferreyra S, Gutmann JL. Healing of a horizontal root fracture with lateral luxation of the coronal fragment: A 3-year follow-up ENDO (Lond Engl). 2013;7:291–297.
- Orhan K, Orhan AI, Tulga F. Management of untreated traumatized permanent incisors with crown and root fractures: A case report. Quintessence Int. 2009;40:647–654.
- Robertson A. A retrospective evaluation of patients with uncomplicated crown fractures and luxation injuries. Endod Dent Traumatol. 1998;14:245–256.
- Wang Z, Heffernan M, Vann WF Jr. Management of a complicated crown-root fracture in a young permanent incisor using intentional replantation. Dent Traumatol. 2008;24:100–103.
- Bevelander G. Tissue reactions in experimental tooth fracture. J Dent Res. 1942;21:481–487.
- DiAngelis AJ, Andreasen JO, Ebeleseder KA, et al. Guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol. 2012;28:2–12.
- Mackie IC, Quayle AA. Alternative management of a crown root fractured tooth in a child. Br Dent J. 1992;173:60–62.
- Simpson HE. Histological changes on retained roots. J Can Dent Assoc. 1959;25:287.
- Glickman I, Pruzansky S, Ostrach M. The healing of extraction wounds in the presence of retained root remnants and bone fragments. Am J Orthod. 1974;33:263.
- Von Wowern N, Winther S. Submergence of roots for alveolar ridge preservation. Int J Oral Surg. 1981;10:247–250.
- Sharma A, Oberoi SS, Saxena S. Submergence of vital roots for the preservation of residual ridge: A clinical study. Oral Health Prev Dent. 2012;10:259–265.
- Renton T, Hankins M, Sproate C, McGurk M. A randomised controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and removal of mandibular third molars. Br J Oral Maxillofac Surg. 2005;43:7–12.
- Johnson BR, Jensen MR. Treatment of a horizontal root fracture by vital root submergence. Endod Dent Traumatol. 1997;13:248–250.