From the Guidelines
Treatment for a tooth fracture should be guided by the severity of the break, with minor chips potentially repairable with dental bonding and more significant fractures requiring a dental crown or even root canal treatment if the pulp is exposed, as indicated by studies such as 1. The approach to treating a tooth fracture involves several key considerations, including the extent of the fracture, whether the pulp is exposed, and the overall health of the tooth.
- For uncomplicated crown fractures where only the enamel and dentin are affected without pulp exposure, restoration with tooth-colored material or rebonding of the tooth fragment can be sufficient, as noted in 1.
- When the fracture exposes the pulp, immediate pulp therapy by a dentist is crucial to preserve pulp vitality, especially in young permanent teeth, as emphasized in 1 and 1.
- The distinction between primary and permanent dentition is important, with different treatment recommendations applying to each, such as the potential for pulpotomy or pulpectomy in primary teeth versus root canal treatment in permanent teeth, as discussed in 1.
- Immediate pain management can include over-the-counter pain relievers like ibuprofen or acetaminophen, and applying a cold compress to reduce swelling, with temporary dental cement used to protect exposed areas until professional treatment can be obtained, as suggested in the examples.
- The importance of prompt dental care cannot be overstated, as untreated fractures can lead to infection, further damage, or tooth loss, highlighting the need for immediate assessment and treatment by a dental professional, as implied by the various studies including 1 and 1.
- A systematic approach to assessing dental trauma, including a thorough medical and dental history, clinical examination, and appropriate radiographic techniques, is essential for determining the extent of the injury and guiding treatment, as outlined in 1.
From the Research
Treatment Options for Tooth Fracture
- Restorative procedures using composite resin and mouthguards for prevention can be used to treat tooth fractures 2
- Endodontic and restorative considerations are of primary significance in the treatment of tooth fractures, with a protective dressing applied as part of the emergency treatment 3
- The fractured tooth fragment can be reattached using adhesive protocols to restore function and esthetic appearance, or current composite materials can be used to achieve excellent esthetic results 3
Restoration Methods
- Reattachment of the fractured fragment and direct composite restorations are two common methods used to restore teeth with crown fractures 4
- Composite restorations have been shown to have a significantly higher survival rate than reattachments, with a cumulative survival after 2 years of 65.0% for composite restorations and 42.9% for reattachments 4
- Fiber-reinforced composites have been found to increase the fracture resistance of endodontically treated teeth compared to traditional hybrid composites 5
Case Studies
- A case study of a complicated crown-root fracture treated using adhesive fragment reattachment and composite resin restoration showed successful results after a two-year follow-up, with healthy periodontal tissues and no signs of periradicular pathology 6
- The use of a fiber-reinforced post to create a central support stump can be an effective way to restore dental morphology in cases of complex crown fractures 6