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This article describes the immediate and definitive options for treating a child or young person presenting with a fractured permanent incisor. Furthermore, it considers three common clinical problems that dentists may encounter when restoring these teeth, and provides advice on how to overcome these difficulties. This article also aims to increase the reader's awareness of the importance of providing an optimal restoration for young patients, and the potential short- and long-term consequences of failing restorations.
CPD/Clinical Relevance: This article aims to guide the reader through the recommended techniques for restoring fractured permanent incisors in young patients and demonstrate how to manage common clinical challenges, while highlighting the importance of providing an optimal restoration.
Article
In dental practice, the presentation of a child with a crown fracture is a regular occurrence, with the incidence of traumatic dental injuries peaking around the ages of 7–12, with males more likely to suffer a traumatic injury than their female counterparts.1,2,3,4 While a crown fracture alone is not the most severe dental injury, it is one of the most common, accounting for 26–76% of injuries to permanent teeth.5
The prognosis of a tooth with a crown fracture is dependent on a number of factors, including:
The clinical consequences of a crown fracture include: development of pulpal necrosis, resorption, infection and loss of tooth. Concomitant injury to the periodontal ligament results in a disruption to pulpal circulation, reducing healing capacity. It also provides bacteria with access to pulpal tissue, increasing the risk of inflammation and subsequent pulpal death.8
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