Dental Trauma

DENTAL TRAUMA: This 12 yo healthy boy presented to our office after his face had an unfortunate meeting with a bed railing while studying with his father. Fortunately, his parents were mindful enough to bring the fracture incisal edge with them to the appointment. Clinical exam determined that this is an Uncomplicated Crown Fracture (Ellis Class II). Although there was no pulp exposure, we can see blushing of the dentin from the occlusal photo. Pulp vitality testing was inconclusive because he was non-responsive to thermal stimulus; this is very common and traumatized teeth can be non-responsive for up to 2-3 months. Due to the large size of the pulp chamber, it was decided to bond the fractured incisal piece with long term follow-up to assess pulp vitality and tooth development. The mother was informed that we speculate that endodontic treatment is forecasted in the future, but we would prefer to see more root thickening. We cored out the pulp horns of the fractured incisal piece, added retention grooves, and bonded the fractured piece with a mixture of composites to best emulate natural coloration and esthetics. We wish the best to our friend and will be monitoring his tooth in the months/years to come.