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Article: Volume 49 Number 2 Page 103 - February 2022

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  Dental Update 497: 103-109

Paediatric dentistry:  Decision-making in the Management of Complicated Crown Fractures in Children

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Abstract: Complicated crown fractures of permanent teeth following dental trauma in children are a common presentation in the dental practice. The prognosis of these teeth largely depends on the emergency management provided by the dentist. Treatment options include direct pulp capping and partial pulpotomy. While both have been suggested as possible vital pulp therapies for the management of complicated crown fractures, there are no clear recommendations as to when each procedure is indicated to aid the clinician in decision making. This narrative review aims to provide evidence-based recommendations for the optimal management of complicated crown fractures in children. The factors affecting success rates of both direct pulp capping and partial pulpotomy are discussed and a step-by-step guide to carrying out a partial pulpotomy is presented.

Clinical relevance: This article will assist clinicians in making an evidence-based decision for the optimal management of complicated crown fractures of permanent teeth in children.

Author notes: Ioanna Politi, BA, BDentSc, MFDS (RCSI), Dental Core Trainee, Department of Oral and Maxillofacial Surgery, Kings College Hospital, London. Rona Leith, BA, BDentSc, DChDent, FFD, FIADT, Assistant Professor, Department of Public and Child Dental Health, Dublin Dental University Hospital. email: ioanna.politi@nhs.net

Objective: The reader should understand the difference in success rates between direct pulp capping and partial pulpotomy, and when these procedures are indicated.