PDF: Complicated crown fracture: a case report

Traumatic injuries to immature permanent teeth represent a serious endodontic challenge. If the pulp becomes necrotic, pulpectomy and root canal therapy will be the treatment of choice.

If the root apex is not completely formed, obturation becomes an extremely difficult procedure, especially when thermoplasticized gutta-percha is used.

Apexification with calcium hydroxide has become the standard treatment choice to provide an apical stop and avoid possible overfilling. 

The main purpose of apexification is to induce the formation of a mineralized barrier at the apex so that the obturation materials do not get thrown into the periapical tissues. However, it is a very time-consuming procedure.

Mineral Trioxide Aggregate (MTA) has been indicated as a suitable material for apexification of immature roots based on its ability of inducing hard tissue formation.

Several studies have reported its excellent biocompatibility, sealing ability and mechanical properties as apical sealing material.

In addition, its relatively fast setting time makes MTA a reliable material to be used as a plug in cases of open apexes, in a singlestep procedure, whereas treatment with calcium hydroxide may take months.

This case report describes the treatment of a severe crown fracture of an immature mandibular permanent incisor in a 12 year-old boy referred to the Dental Traumatology Center of UNIGRANRIO University.