PMC7492961_01
Fracture with pulp exposure in both incisors.
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An 8-year-old male patient was sent for management after 3 days of an enamel-dentine-pulp fracture in the upper left central incisor (number 21) and crown-root fracture with pulp exposure in the upper right central incisor (number 11) (Figures 1-4).
Midcrown fracture with small pulp exposure in tooth no. 21 and crown-root fracture with protrusive pulp reaction in tooth no. 11.
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An 8-year-old male patient was sent for management after 3 days of an enamel-dentine-pulp fracture in the upper left central incisor (number 21) and crown-root fracture with pulp exposure in the upper right central incisor (number 11) (Figures 1-4).
Frontal view of the patient.
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An 8-year-old male patient was sent for management after 3 days of an enamel-dentine-pulp fracture in the upper left central incisor (number 21) and crown-root fracture with pulp exposure in the upper right central incisor (number 11) (Figures 1-4).
Panoramic radiography 3 days after trauma.
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An 8-year-old male patient was sent for management after 3 days of an enamel-dentine-pulp fracture in the upper left central incisor (number 21) and crown-root fracture with pulp exposure in the upper right central incisor (number 11) (Figures 1-4).
Pulpotomy of tooth no. 21 (a and b) and tooth no. 11 after removal of the palatine tooth fragment and after partial pulpotomy (c) with MTA application (d).
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After 10 minutes, a glass ionomer (Vitrabond Plus, 3M ESPE, USA) was applied over the MTA, and the patient was dismissed (Figure 5).
2 weeks later, the glass ionomer was partially removed and direct composite restoration was concluded.
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The glass-ionomer restoration was partially removed, and directly bonded composite restoration was performed (IPS Empress Direct, IvoclarVivadent, Schaan, Liechtenstein) with gum retraction (Ultrapak 1, Ultradent, Utah, USA) (Figure 6).
Periapical radiography, at 2 months (a), 1 year (b), 2 years (c), and 3 years (d) after trauma.
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During the 6-month follow-up and from 1 to 5 years, the situation remained unchanged with no evidence of radiolucent lesions in radiographic examinations (Figure 7). Follow-up shows a continuation of root development and the creation of hard tissue at the site of the incision (Figure 7).
CBCT 5 years after trauma with a normal appearance.
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Cone-beam computerized tomography (CBCT) was used to monitor healing during the 5-year follow-up, allowing 3D visualization of the periapical area and discarding the existence of root resorption (Figure 8).
Follow-up after 6 months (up) and 3 years (down) with cervical discoloration in tooth no. 21.
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Light discoloration in the crown of 21 was evident at 3 years follow-up (Figure 9), but it did not disturb the patient or his family, so it was not addressed.