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LETTER TO EDITOR
Year : 2017  |  Volume : 9  |  Issue : 1  |  Page : 63

Alternative treatment for complicated crown fracture


1 Department of Conservative Dentistry, School of Dental Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
2 Department of Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan

Date of Web Publication14-Jun-2017

Correspondence Address:
Tahir Yusuf Noorani
Department of Conservative Dentistry, School of Dental Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan
Malaysia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-8844.207948

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How to cite this article:
Noorani TY, Siddiqu YD. Alternative treatment for complicated crown fracture. J Orofac Sci 2017;9:63

How to cite this URL:
Noorani TY, Siddiqu YD. Alternative treatment for complicated crown fracture. J Orofac Sci [serial online] 2017 [cited 2023 Feb 1];9:63. Available from: https://www.jofs.in/text.asp?2017/9/1/63/207948



Sir,

We write to you in regard to the article, “Dental trauma associated with high impact sport” authored by Goiato et al.[1] in January 2015 issue of Journal of Orofacial Sciences. The case report has been well written, and a conservative treatment modality has been highlighted. However, we would like to suggest a crucial alternative treatment modality that could be carried out with predictable results that is Cvek pulpotomy or partial pulpotomy.

In the case presented,[1] the reason for endodontic treatment has been indicated as long-term exposure to the oral environment which was around 12 h. Nevertheless, studies have shown that the time between the injury and treatment has little or no effect on the outcome of Cvek pulpotomy.[2],[3] Teeth with traumatic pulp exposure for as long as 4 days were successfully treated with Cvek pulpotomy. This was even true when roots of traumatized teeth were completely formed.

In the case presented,[1] pulp sensibility testing was not carried out to investigate the status of the pulp. Furthermore, the patient was young, wherein the success of pulpotomy is greater due to the higher cellular content in dental pulps of young teeth. In addition, in the only radiograph that has been provided by the authors, there is no sign of any periapical pathology. Although the authors have stated that the patient had pain following trauma, it is not stated that pain was continuous in nature, which may indicate that the pulp is not irreversibly inflamed. Besides, the pain reported by the patient could be due to pulp exposure following trauma. Furthermore, the tooth was restored conservatively which further emphasizes the importance of Cvek pulpotomy in this case. This is due to the fact that additional retention for an extra coronal restoration from the root canal system using a post and core was not required. Likewise, maintaining the vitality of young permanent teeth cannot be overemphasized as it will result in continued dentine deposition in the cervical area, thus strengthening the tooth.[2] Moreover, Cvek pulpotomy may be considered as a more economic treatment in comparison to endodontic treatment. Hence, irrespective of the root development stage, an attempt to maintain the vitality of traumatized young permanent teeth using Cvek pulpotomy should always be attempted. Besides with the advent of materials such as mineral trioxide aggregate, the outcomes of vital pulp therapy have become more predictable.[4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Goiato MC, da Rocha Bonatto L, da Silva EV, Vechiato-Filho AJ, de Medeiros RA, dos Santos DM. Dental trauma associated with high impact sport. J Orofac Sci 2015;7:63-5.  Back to cited text no. 1
  [Full text]  
2.
Cvek M. A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture. J Endod 1978;4:232-7.  Back to cited text no. 2
    
3.
Fuks AB, Cosack A, Klein H, Eidelman E. Partial pulpotomy as a treatment alternative for exposed pulps in crown-fractured permanent incisors. Endod Dent Traumatol 1987;3:100-2.  Back to cited text no. 3
    
4.
Akhlaghi N, Khademi A. Outcomes of vital pulp therapy in permanent teeth with different medicaments based on review of the literature. Dent Res J (Isfahan) 2015;12:406-17.  Back to cited text no. 4
    




 

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