MTA Cvek Pulpotomy Followed by Fragment Re-Attachment in Traumatized Young Permanent Maxillary Left Central Incisor – A Case Report

Abstract

ost common injuries in children and young adults are the Traumatic dental injuries (TDIs). Among all the dental injuries, luxations and crown fractures occurs more frequently. Maxillary Central incisor 80% followed by maxillary lateral incisor 20% are the commonly affected teeth because of their position in the arch.1 According to Andreason s classification, Dental fractures involving enamel, or both dentin and enamel but without puplal exposure are termed as uncomplicated crown fractures. But when the fracture is associated with pulp exposure, it is classified as a complicated crown fracture and an endodontic treatment should be considered before the definitive treatment. Approximately 18-20% of all traumatic injuries to permanent teeth are complicated crown fractures.2 Management of coronal tooth fractures depends on multiple factors which include extent and pattern of fracture, involvement of pulp tissue, violation of biological width, fracture of alveolus, any associated soft tissue injury and presence or absence of fractured tooth segment.3 In young permanent teeth, the treatment of crown fractures with pulp exposure highly depends on extent of pulp tissue involvement, the degree of development of root and most importantly the time period between the examination and traumatic incident.3 Pulp should be preserved whenever possible in such teeth with immature roots to allow root formation and tooth maturation. Pulp capping is recommended when size of pulpal exposure is less then 1 mm2 and the duration of exposure at the time of treatment should not be more then few hours.4 Cvek pulpotomy which is a technique of partial pulpotomy, is considered as treatment of choice when pulpal exposure is more than 1mm2 and time lapse is long between the incident and examination.4 Until 1983 calcium hydroxide mixture was used as a dressing material to initiate reparative dentin formation by 1. MDS (Resident), Post graduate, Department of Pediatric Dentistry, Pakistan Institute of Medical Sciences. 2. House officer, Department of Pediatric Dentistry, Pakistan Institute of Medical Sciences. 3. Registrar, Department of Operative Dentistry, University College of Dentistry. 4. Dean of Dentistry, Department of Operative & Pediatric Dentistry, Pakistan Institute of Medical Sciences. 5. FCPS (Resident), Post graduate, Department of Orthodontics, Sardar Begum Dental College. 6. MDS (Resident), Post graduate, Department of Pediatric Dentistry, Pakistan Institute of Medical Sciences. Corresponding author: “Dr. Abul Khair Zalan” < [email protected] >