Alves M D, Tateyama M A, Pavan Nno, Queiroz A F, Nunes McP, Endo M S
Morgana Ducatti Alves, DDS, State University of Maringa Health Science Center, Maringá, Brazil.
*Mellissa Ayumi Tateyama, DDS, State University of Maringa Health Science Center, Maringá, Brazil.
Oper Dent. 2021 Sep 1;46(5):484-490. doi: 10.2341/20-015-S.
Treatment of complicated crown-root fractures is one of the most challenging within the various types of dental trauma and requires a multidisciplinary approach. This paper reports the complicated crown-root fracture of a maxillary right central incisor, in which there was esthetic, functional, and biologic (endodontic and biologic width invasion) involvement. A 15-year-old male patient presented to the dental clinic one month after suffering trauma with a complicated crown-root fracture on tooth 8. The patient had previously undergone endodontic treatment and was sent to have periodontal surgery to reestablish the biological width on the palatal surface. Following the surgery, a fiberglass post was cemented, and the fragment was reattached. This approach allows the exposure of the cervical margin, adequate isolation, and subsequent fragment reattachment in the same clinical appointment. Fragment reattachment is a viable approach as it is a simple and conservative procedure that restores the natural esthetic of the tooth and has superior resistance compared to a composite restoration. The patient's cooperation in understanding the limitations of the treatment and maintaining adequate oral hygiene are very important to achieving a good prognosis of the case. After a 2-year clinical and radiographic follow-up period, the clinical protocol was found to be successful, and the tooth remained functional, esthetically favorable and asymptomatic.
复杂冠根折的治疗是各类牙外伤中最具挑战性的治疗之一，需要多学科方法。本文报告一例上颌右侧中切牙复杂冠根折，涉及美观、功能及生物学方面（牙髓及生物学宽度侵犯）。一名15岁男性患者在牙齿8遭受复杂冠根折外伤1个月后就诊于牙科诊所。该患者此前已接受牙髓治疗，并被送去进行牙周手术以重建腭侧生物学宽度。手术后，粘结了一根玻璃纤维桩，并将碎片重新附着。这种方法可在同一次临床就诊中暴露颈部边缘、充分隔离并随后重新附着碎片。碎片重新附着是一种可行的方法，因为它是一种简单且保守的程序，可恢复牙齿的自然美观，并且与复合树脂修复相比具有更好的抗力。患者理解治疗局限性并保持良好口腔卫生对于该病例获得良好预后非常重要。经过2年的临床和影像学随访期，发现该临床方案是成功的，牙齿保持功能正常、美观且无症状。
