Clinical case: complicated crown-root fracture of a tooth with an immature root

Abstract

According to the latest WHO estimate, dental trauma affects 1 billion people worldwide, and its prevalence among children under 12 years of age is 20%. Dental trauma accounts for 5% of all types of traumas. Dental injuries are the fifth most common disease. This article shows the importance of choosing tactics for the treatment of traumatic dental injuries in children; an example is given of the rehabilitation of a patient of primary school age with a crown-root fracture of a tooth with an immature root. The purpose of the study is to evaluate the results of delayed observation after treatment of a complicated crown-root fracture of a permanent tooth with an immature root using the method of vital amputation.
Materials and methods.
A clinical case of diagnosis and treatment of a complicated crown-root fracture of a permanent tooth with an immature root is described. Thermal diagnostics of the tooth, radiation diagnostics using cone-beam computed tomography and radiovisiography were carried out. Under conditions of general anesthesia, the working field was isolated using a rubber dam system, deep amputation of the pulp was performed, and vital pulp was isolated using the biocompatible cement Biodentine (calcium silicate-based cement). Temporary tooth restoration with composite material Estelite Asteria.
Results.
Based on the results of observation of the patient for 2 years, the completion of the growth of the roots of teeth 1.1 and 2.1 in length was revealed, the stage of closure of the apical foramen of the root was determined, no visible pathological changes in the bone tissue were determined. The cold test of teeth 1.1 and 2.1 is positive and passes quickly. During 2.5 years of observation, the patient did not report any pain in the area of the injured teeth. The color of the teeth is not changed, percussion is painless, the restorations are satisfactory, the mucous in the area of tooth 1.1 is without pathological signs, painless on palpation.
Conclusion.
When treating a complicated crown-root fracture of a permanent tooth with an immature root, it is important to choose methods that preserve the vital pulp in order to create conditions for continued growth of the root in length and improve the long-term prognosis after treatment.