IP Indian Journal of Conservative and Endodontics 2020;5(3):144–146
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IP Indian Journal of Conservative and Endodontics
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Case Report
The treatment strategy of an oblique complicated crown-root fracture: A case
report
Nazia Ali
1,
*, Ipsita Pathak
1
, Vipul Srivastava
1
, Ayush Razdan Singh
1
1
Dept. of Conservative Dentistry & Endodontics, Saraswati Dental College, Lucknow, Uttar Pradesh, India
ARTICLE INFO
Article history:
Received 25-08-2020
Accepted 03-09-2020
Available online 07-09-2020
Keywords:
Crownroot fracture
Fiber post
Reattachment
Monoblock
ABSTRACT
A crown-root fracture is defined as a fracture which involve enamel; dentin and root cementum with or
without the involvement of pulp. If pulp is involved it is known as complicated crown-root fracture. It is
usually oblique in nature involving both crown and root. In this case report we have a case of 20 year old
female with oblique complicated crown-root fracture and an irreversible pulpitis of maxillary left canine.
In this case endodontic therapy followed by reattachment of fractured fragment with a prefabricated fiber
post followed by PFM crown was the treatment plan for the patient and patient responded successfully to
treatment..
© 2020 Published by Innovative Publication. This is an open access article under the CC BY-NC license
(https://creativecommons.org/licenses/by-nc/4.0/)
1. Introduction
The most commonly involved teeth in dental trauma
are maxillary incisors. During dental trauma sometimes
a complicated crown-root fracture occurs which is
characterized by a fracture that involve enamel, dentin,
cementum with pulpal involvement. Crown-root fractures
extending apically towards both the gingival margin and
the alveolar crest pose a great challenge.
1–3
Gingivectomy,
osteotomy, orthodontic extrusion, surgical extrusion,
intentional replantation or extraction are various methods
for the management of complicated crown-root frcture.
4
Whenever there is no or minimal invasion of the biological
width and fragment of tooth is intact, reattachment of
fractured fragment of tooth by fiber post is most favourable
treatment procedure.
4–6
2. Case Report
A 20 year-old female patient presented at to the Department
of Conservative dentistry and endodontics of Saraswati
dental college and hospitals lucknow, and complains of pain
* Corresponding author.
E-mail address: naziaa258@gmail.com (N. Ali).
in maxillary left canine. The patient had a history of accident
2 days ago.
There was nothing significant in past medical history.
The soft tissue, temporomandibular joint and osseous
structures did not show any injury on initial clinical
examination Left maxillary canine was tender on percussion
and slightly mobile but not displaced on intraoral
examination. Cold test was used to check the pulp vitality
of maxillary left canine and showed intense pain response.
Intraoral periapical radiographic examination revealed an
oblique crown root fracture in maxillary left canine by
taking radiograph from different angles., A diagnosis of
oblique crown-root fracture and irreversible pulpitis in
maxillary left canine was made based on the clinical
and radiographic examination. Treatment plan selected for
patient was root canal treatment followed by reattachment of
the crowns by using fiber-reinforced post followed by PFM
crown.
Root canal treatment was performed in single
appointment under local anesthesia. The pulp was
extirpated and the root canal was cleaned, shaped and filled.
Post space was prepared and fiber posts of corresponding
size was positioned in the canal and its fit was checked by
radiograph. Tooth preparation was done in next appointment
https://doi.org/10.18231/j.ijce.2020.034
2581-9534/© 2020 Innovative Publication, All rights reserved. 144