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 Table of Contents  
CASE REPORT
Year : 2018  |  Volume : 4  |  Issue : 1  |  Page : 60-62

Single sitting endodontic management of complicated crown root fracture of maxillary incisor with a fibre post- A case report


1 Senior Resident, Department of Dentistry, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, India
2 Assistant Professor, Department of Dentistry, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, India
3 Professor and Head, Department of Dentistry, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, India
4 Additional Professor, Department of Dentistry, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, India
5 M.D.S, Consultant Prosthodontist, Patna, India

Date of Web Publication10-Dec-2020

Correspondence Address:
Devika Singh
Department of Dentistry Indira Gandhi, Institute of Medical Sciences, Sheikhpura, Patna-14, Bihar
India
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Source of Support: None, Conflict of Interest: None


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  Abstract 


Dental traumatic injuries occur in 2-5% of the cases, most commonly involving the maxillary incisors. The resultant traumatic injuries cause immediate disfigurement resulting in unappealing aesthetics which can make an individual psychologically depressed and socially restrained. A fractured tooth or a malposed tooth can give an individual a reason to feel conscious about oneself. With the advancement in cosmetic dentistry and endodontics, the aforementioned plethora of esthetic woes can be changed and restored to more desirable form. Treatment protocol will depend on a number of factors which are:- preservation of natural tooth structure, patient’s expectations and the expertise of the treating doctor. The present case report emphasizes on immediate aesthetic management of crown root fracture with a fibre post followed by composite restoration; all aimed at providing the ‘Perfect Smile’.

Keywords: Fibre Post, Aesthetic, Fractured Anteriors


How to cite this article:
Singh D, Gupta P, Mishra N, Sharma A K, Kumar S, Pranab A. Single sitting endodontic management of complicated crown root fracture of maxillary incisor with a fibre post- A case report. J Indira Gandhi Inst Med Sci 2018;4:60-2

How to cite this URL:
Singh D, Gupta P, Mishra N, Sharma A K, Kumar S, Pranab A. Single sitting endodontic management of complicated crown root fracture of maxillary incisor with a fibre post- A case report. J Indira Gandhi Inst Med Sci [serial online] 2018 [cited 2022 Jan 20];4:60-2. Available from: http://www.jigims.co.in/text.asp?2018/4/1/60/302991




  Introduction : Top


A crown-root fracture is a type of dental trauma occurring below the gingival margin that involves enamel, dentin and cementum. It may be classified as complicated or uncomplicated, depending on whether the pulp is involved[1]. Epidemiological studies reveal that crown-root fractures represent 5% of dental injuries, and most of these injuries occur in permanent maxillary incisors[1],[2],[3]. Fractures of these teeth can cause aesthetic, functional, and psychological problems for the patient[2]. Therefore, treatment of complicated crown-root fractures is important but often challenging especially when the biologic width has been violated.

WHO classified Dental Traumatic injuries under the following headings

  1. Injuries to the dental hard tissue and pulp
  2. Injuries to the dental hard tissue, pulp and to the alveolar process
  3. Injuries to the periodontium
  4. Injuries to the gingiva and/or oral mucosa











  Case Report : Top


A 20-year-old male reported to the Department of Dentistry, IGIMS, Patna with the chief complaint of a fractured tooth in upper front tooth region. The patient gave history that he met with an accident on the same day and fractured his tooth after his head hit the handle of his vehicle [Figure 1]. The patient did not give history of any other associated symptoms. There was no relevant past dental or medical history. After radiographic evaluation the patient was explained about the status of the tooth and was advised to undergo endodontic treatment. Single sitting Root Canal Treatment was done in the anterior tooth and a fibre post was placed [Figure 2]. After the placement of the fibre post, a composite built up was done to mimic permanent anterior teeth [Figure 3]. The patient was recalled after one week for follow up. The patient did not give history of any pain, swelling and any other discomfort.
Figure 1: Ellis Class III Fracture involving 11

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Figure 2: Endodontic Treatment Followed by Fibre Post with respect to 11

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Figure 3: Composite Built Up

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  Discussion : Top


The life of an endodontically treated teeth has been greatly enhanced by continuing developments made in endodontic and restorative procedures.[4],[5] Endodontic treatment saves the tooth from extraction, but only adequate restoration is essential for its durability. The endodontically treated tooth must be restored in such a way that it will withstand masticatory forces acting in vertical and lateral direction without being prone to fracture. To reinforce the treated tooth and protect against vertical fracture, some type of stabilization is required that will fasten the restoration to the remaining tooth structure. This is accomplished by using a post. Newer post systems arecontinuously being introduced into the market. The general trend is towards more aesthetic dentistry and a keen interest to achieve good appearance and translucency due to which the restoration should mimic that of a natural tooth[6].

In the restoration of traumatized anterior teeth, both esthetic and mechanical considerations should be taken into account. In these two case reports, fiber posts and esthetic restorative treatment. fiber posts provide retention to the core and supports it against occlusion forces[7]. The effectiveness of this combined system was confirmed after follow-up examinations. For fractured anterior teeth, there are several treatment alternatives such as composite resinrestorations and prosthetic repair[8]. However, a fiber post and composite restorations, which have lower chair time and minimal tissue removal, could be an admirable alternative.

Various posts systems have been introduced in the market and the research indicates that they can be safely included in the clinical practice. The selected post and core technique must be conservative, morphologic, retentive, aesthetic and resist radicular failure. The available laboratory and clinical evidence validates the utilization of fibre posts as an alternative to metal posts and preferably to other tooth-colored posts, such as zirconia dowels, in post-retained restorations. Each clinical situation will dictate to some degree what post system will be used and for those situations where there is choice, personal preference, familiarity and cost will influence the final decision.

However, clinicians are advised to follow guidelines and recommendations for post selection and core fabrication followed by crown design[6].



 
  References Top

1.
Olsburgh S, Jacoby T, KrejciI : Crown fractures in the permanent dentition: pulpal and restorative considerations. Dent Traunatol, 18:103-115, 2002.  Back to cited text no. 1
    
2.
Ortolan SM, Strujic M, Mehulic K, et al. :Esthetic rehabilitation of complicated crown fractures utilizing rapid orthodontic extrusion and two different restoration modalities. Int J ClinPesiatr Dent, 5: 64-67, 2012.  Back to cited text no. 2
    
3.
Fidel SR, Fidel-Junior RA, Fidel RA, et al. : Clinical management of a complicated crown-root fracture: A case report. Braz Dent J, 22:258-262, 2011.  Back to cited text no. 3
    
4.
Goyal Shivali, Mittal Sanjeev Prosthodontic Management of endodontically treated teeth-A review Journal of Pearldent 2014;5(4):13-19.  Back to cited text no. 4
    
5.
K.S. Sridhara, Sunil Mankar, C.M. Jayshankar, K Vinaya .Scanning electron microscopic study of teeth restored with fibre posts and composite resin: An in vitro study Journal of Pharmacy and Bioallied Sciences 2014;6 (supp 1): S74-S79.  Back to cited text no. 5
    
6.
Jhavar N, Bhondwe S, Mahajan V, Dhoot R.Recent Advances in Post Systems: A Review JOADMS 2015;1(3):128-136.  Back to cited text no. 6
    
7.
Asmussen E, Peutzfeldt A, Heitmann T. Stiffness, elastic limit, and strength of newer types of endodontic posts. J Dent. 1999;27(4):275-8.  Back to cited text no. 7
    
8.
Ozel E, Kazandag MK, Soyman M, BayirliG.Two-year follow-up of fractured anterior teeth restored with direct composite resin: report of three cases. Dent Traumatol. 2008;24(5):589-92.  Back to cited text no. 8
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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