Management of Crown Fractures Flashcards
When should immature incisors be root treated and what is the clinical problem with this?
If tooth is non-vital full pulpectomy is required
Clinical problem - no apical stop to allow obturación with GP
What are the management options for root treatment of immature incisors?
CaOH placed in canal aiming to induce hard tissue barrier to form (apexification)
MTA/BioDentine placed at apex of canal to create cement barrier - most common option
Regenerative endodontic technique to encourage hard tissue formation at apex
Describe a pulpectomy with an open apex
Rubber dam and good access
Haemorrhage control - LA and sterile water
Diagnostic radiograph for WL
File 2mm short of estimated WL
Dry canal, non setting CaOH, CW in pulp chamber
GIC in access cavity and evaluate CaOH fill level with radiograph
What is the best practice for a pulpectomy with an open apex?
Extirpate pulp and place CaOH for no longer than 4-6 weeks after identified as non-vital
If problems with CaOH apexification then MTA plug and heated GP obturation
Describe a final coronal restoration for a pulpectomy with an open apex
Place once obturation is complete
Consider bonded composite short way down canal as well as in access cavity
Bonded core
Try to avoid post crown
What are the treatment options for a crown-root fracture with no pulp exposure?
Fragment removal only and restore
Fragment removal and gingivectomy
Orthodontic extrusion of apical portion
Surgical extrusion
Decoronation
Extraction
When is fragment removal and gingivectomy indicated?
In crown-root fractures with palatal subgingival extension
What is decoronation?
Remove crown and leave root
Preserves bone for future implant
What are the treatment options for a crown-root fracture with a pulp exposure?
Can be temporised with composite for up to 2 weeks
Fragment removal and gingivectomy
Orthodontic extrusion of apical portion
Surgical extrusion
Decoronation
Extraction
