%0 Journal Article
%T Management and Followup of Complicated Crown Fractures in Young Patients Treated with Partial Pulpotomy
%A Francisco Ojeda-Gutierrez
%A Brenda Martinez-Marquez
%A Soraya Arteaga-Larios
%A M. Socorro Ruiz-Rodriguez
%A Amaury Pozos-Guillen
%J Case Reports in Dentistry
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/597563
%X Two cases of young patients with traumatized permanent teeth having complicated crown fractures are reported. Endodontic management included partial pulpotomy by the Cvek technique; restorative management included resin restoration and reattachment of the teeth fragments. Treatments were considered successful in all cases according to the following criteria: absence of clinical symptoms, absence of X-ray signs of pathology, and presence of pulpal vitality 6 to 25 months after treatment. 1. Introduction Trauma to the facial area represents a public health problem involving children and adolescents; it generally involves the teeth and their supporting structures. The most frequent causes are falls, traffic accidents, domestic violence, fights, and sports. Most dental injuries occur during the first 2 decades of life, especially between 2 and 3 years and between 8 and 12 years of age, occurring more often in boys than in girls [1¨C3]. Dental fractures frequently involve only the enamel, or enamel and dentin, without affecting the pulp [4]. Occasionally, however, the pulp is also involved [5¨C7]. Due to their position, the teeth most frequently affected by dental traumatism are the maxillary incisors: 80% centrals and 16% laterals [8]. Several diagnostic criteria have been used to classify traumatic dental injuries. Ellis and Davery [9], proposed a classification based on a numerical system (I to VIII) and described the extent, using terms like ¡°simple fracture¡± and ¡°complicated fracture¡±; this classification considers X-ray examinations and vitality tests. Treatment of crown fractures with exposed pulp in permanent young teeth depends on the degree of pulp exposure, time between accident and examination, effect of the traumatism, and the stage of root development. Treatment options of crown fractures with pulpal exposure are direct pulp capping, partial pulpotomy, pulpectomy, or extraction. For young patients in whom the exposed pulp maintains its vitality, pulpotomy is the best endodontic treatment option in order to maintain pulpal functions [10¨C13]. A partial pulpotomy, known as the Cvek technique, is indicated for teeth having the following characteristics: small pulp exposure, treated within 14 days of trauma, caries-free, open apex or thin dentinal walls, and vital and asymptomatic pulp. This technique involves amputation of the pulp 2£¿mm apical to the affected pulp tissue, but it is not recommended for those cases in which the pulp exposure is extensive or where there has been a 2-week lapse between trauma and treatment [14]. The aim of the present
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