全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Management and Followup of Complicated Crown Fractures in Young Patients Treated with Partial Pulpotomy

DOI: 10.1155/2013/597563

Full-Text   Cite this paper   Add to My Lib

Abstract:

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 [1–3]. Dental fractures frequently involve only the enamel, or enamel and dentin, without affecting the pulp [4]. Occasionally, however, the pulp is also involved [5–7]. 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 [10–13]. 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

References

[1]  American Academy of Pediatric Dentistry Council on Clinical Affairs, “Guidelines on management of acute dental trauma,” Pediatric Dentistry, vol. 30, no. 7, supplement, pp. 175–183, 2009.
[2]  P. C. S. Filho, P. S. Quagliatto, P. C. Simamoto Jr., and C. J. Soares, “Dental trauma: restorative procedures using composite resin and mouthguards for prevention,” Journal of Contemporary Dental Practice, vol. 8, no. 6, pp. 89–95, 2007.
[3]  C. M. Forsberg and G. Tedestam, “Etiological and predisposing factors related to traumatic injuries to permanent teeth,” Swedish Dental Journal, vol. 17, no. 5, pp. 183–190, 1993.
[4]  K. Arapostathis, A. Arhakis, and S. Kalfas, “A modified technique on the reattachment of permanent tooth fragments following dental trauma. Case report,” Journal of Clinical Pediatric Dentistry, vol. 30, no. 1, pp. 29–34, 2005.
[5]  G. Cavalleri and N. Zerman, “Traumatic crown fractures in permanent incisors with immature roots: a follow-up study,” Endodontics & Dental Traumatology, vol. 11, no. 6, pp. 294–296, 1995.
[6]  L. P. De Blanco, “Treatment of crown fractures with pulp exposure,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, vol. 82, no. 5, pp. 564–568, 1996.
[7]  F. Ojeda-Gutierrez, B. Martinez-Marquez, R. Rosales-Ibanez, and A. J. Pozos-Guillen, “Reattachment of anterior teeth fragments using a modified Simonsen's technique after dental trauma: report of a case,” Dental Traumatology, vol. 27, no. 1, pp. 81–85, 2011.
[8]  J. O. Andreasen, “Etiology and pathogenesis of traumatic dental injuries: a clinical study of 1,298 cases,” Scandinavian Journal of Dental Research, vol. 78, no. 4, pp. 329–342, 1970.
[9]  R. G. Ellis and K. Davery, The Classification and Treatment of Injuries to the Teeth of Children, Year Book, Chicago, Ill, USA, 5th edition, 1970.
[10]  J. D. McIntyre and W. F. Vann Jr., “Two case reports of complicated permanent crown fractures treated with partial pulpotomies,” Pediatric Dentistry, vol. 31, no. 2, pp. 117–122, 2009.
[11]  K. C. Huth, E. Paschos, N. Hajek-Al-Khatar et al., “Effectiveness of 4 pulpotomy techniques—randomized controlled trial,” Journal of Dental Research, vol. 84, no. 12, pp. 1144–1148, 2005.
[12]  I. Epelman, P. E. Murray, F. Garcia-Godoy, S. Kuttler, and K. N. Namerow, “A practitioner survey of opinions toward regenerative endodontics,” Journal of Endodontics, vol. 35, no. 9, pp. 1204–1210, 2009.
[13]  F. Garcia-Godoy and P. E. Murray, “Recommendations for using regenerative endodontic procedures in permanent immature traumatized teeth,” Dental Traumatology, vol. 28, no. 1, pp. 33–41, 2012.
[14]  M. Cvek, “A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture,” Journal of Endodontics, vol. 4, no. 8, pp. 232–237, 1978.
[15]  P. Krasner and H. J. Rankow, “New philosophy for the treatment of avulsed teeth,” Oral Surgery, Oral Medicine, Oral Pathology and Endodontics, vol. 79, no. 5, pp. 616–623, 1995.
[16]  M. A. Tapias, R. Jiménez-García, F. Lamas, and A. A. Gil, “Prevalence of traumatic crown fractures to permanent incisors in a childhood population: Móstoles, Spain,” Dental Traumatology, vol. 19, no. 3, pp. 119–122, 2003.
[17]  W. H. Liebenberg, “Direct pulp capping considerations during tooth fragment reattachment: a case report,” The Journal of the Dental Association of South Africa, vol. 48, no. 1, pp. 28–32, 1993.
[18]  E. A. V. Maia, L. N. Baratieri, M. A. C. De Andrada, S. Monteiro Jr., and E. M. De Araújo Jr., “Tooth fragment reattachment: fundamentals of the technique and two case reports,” Quintessence International, vol. 34, no. 2, pp. 99–107, 2003.
[19]  J. O. Andreasen, E. Lauridsen, and J. Daugaard-Jensen, “Dental traumatology: an orphan in pediatric dentistry?” Pediatric Dentistry, vol. 31, no. 2, pp. 153–156, 2009.
[20]  C. D. Fong and M. J. Davis, “Partial pulpotomy for immature permanent teeth, its present and fixture,” Pediatric Dentistry, vol. 24, no. 1, pp. 29–32, 2002.
[21]  A. B. Fuks, A. Cosack, H. Klein, and E. Eidelman, “Partial pulpotomy as a treatment alternative for exposed pulps in crown-fractured permanent incisors,” Endodontics & Dental Traumatology, vol. 3, no. 3, pp. 100–102, 1987.
[22]  R. A. Souza, S. C. N. Gomes, J. D. C. P. Dantas, Y. T. Silva-Sousa, and J. D. Pécora, “Importance of the diagnosis in the pulpotomy of immature permanent teeth,” Brazilian Dental Journal, vol. 18, no. 3, pp. 244–247, 2007.
[23]  D. R. S. Nadia, E. Bresciani, C. E. Francischone, E. B. Franco, and J. C. Pereira, “Partial pulpotomy and tooth reconstruction of a crown-fractured permanent incisor: a case report,” Quintessence International, vol. 34, no. 10, pp. 740–747, 2003.
[24]  I. S. Sonmez and H. Sonmez, “Long-term follow-up of a complicated crown fracture treated by partial pulpotomy,” International Endodontic Journal, vol. 40, no. 5, pp. 398–403, 2007.
[25]  M. Torabinejad and N. Chivian, “Clinical applications of mineral trioxide aggregate,” Journal of Endodontics, vol. 25, no. 3, pp. 197–205, 1999.
[26]  T. Kiatwateeratana, S. Kintarak, S. Piwat, O. Chankanka, S. Kamaolmatyakul, and A. Thearmontree, “Partial pulpotomy on caries-free teeth using enamel matrix derivative or calcium hydroxide: a randomized controlled trial,” International Endodontic Journal, vol. 42, no. 7, pp. 584–592, 2009.
[27]  H. Olsson, J. R. Davies, K. E. Holst, U. Schr?der, and K. Petersson, “Dental pulp capping: effect of emdogain gel on experimentally exposed human pulps,” International Endodontic Journal, vol. 38, no. 3, pp. 186–194, 2005.
[28]  R. S. Schwartz, M. Mauger, D. J. Clement, and W. A. Walker III, “Mineral trioxide aggregate: a new material for endodontics,” Journal of the American Dental Association, vol. 130, no. 7, pp. 967–975, 1999.
[29]  N. T. Ishizaki, K. Matsumoto, Y. Kimura, X. Wang, and A. Yamashita, “Histopathological study of dental pulp tissue capped with enamel matrix derivative,” Journal of Endodontics, vol. 29, no. 3, pp. 176–179, 2003.
[30]  A. Garrocho-Rangel, H. Flores, D. Silva-Herzog, F. Hernandez-Sierra, P. Mandeville, and A. J. Pozos-Guillen, “Efficacy of EMD versus calcium hydroxide in direct pulp capping of primary molars: a randomized controlled clinical trial,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, vol. 107, no. 5, pp. 733–738, 2009.
[31]  A. H. B. Schuurs, R. J. M. Gruythuysen, and P. R. Wesselink, “Pulp capping with adhesive resin-based composite vs. calcium hydroxide: a review,” Dental Traumatology, vol. 16, no. 6, pp. 240–250, 2000.
[32]  F. M. Andreasen, J. G. Norén, J. O. Andreasen, S. Engelhardtsen, and U. Lindh-Str?mberg, “Long-term survival of fragment bonding in the treatment of fractured crowns: a multicenter clinical study,” Quintessence International, vol. 26, no. 10, pp. 669–681, 1995.
[33]  P. E. Murray, I. About, P. J. Lumley, G. Smith, J. C. Franquin, and A. J. Smith, “Postoperative pulpal and repair responses,” Journal of the American Dental Association, vol. 131, no. 3, pp. 321–329, 2000.
[34]  D. Tziafas, A. J. Smith, and H. Lesot, “Designing new treatment strategies in vital pulp therapy,” Journal of Dentistry, vol. 28, no. 2, pp. 77–92, 2000.
[35]  I. Jacobsen and B. U. Zachrisson, “Repair of characteristics of root fractures in permanent anterior teeth,” Scandinavian Journal of Dental Research, vol. 83, no. 6, pp. 355–364, 1975.
[36]  L. Feely, I. C. Mackie, and T. Macfarlane, “An investigation of root-fractured permanent incisor teeth in children,” Dental Traumatology, vol. 19, no. 1, pp. 52–54, 2003.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133