Crown Fracture – Uncomplicated

Image: An uncomplicated crown fracture.

An uncomplicated crown fracture involves only enamel or enamel/dentin structure without involvement of the pulp. Clinical and/or radiographic findings reveal a loss of tooth structure consisting of only enamel or both the enamel and dentin. Injured lips, tongue and gingiva should be examined for embedded tooth fragments and debris. Pulp sensibility testing is recommended to monitor pulpal health changes in adult teeth but is unreliable in primary teeth. Initial testing may be negative initially indicating transient pulpal damage.

Treatment objectives are to maintain pulp vitality and restore normal esthetics and function. For small fractures, rough margins and edges may be smoothed. For larger fractures, lost tooth structure may be restored with calcium hydroxide (if the fracture is close to the pulp), glass ionomer cement and composite. The prognosis of uncomplicated crown fractures depends primarily upon associated injuries to the periodontal ligament and secondarily upon the extent of dentin exposed. Follow up clinical and radiographic exam should be scheduled at three to four weeks in children, six to eight weeks in adults and one year for all ages.