Crown Fractures

Crown fractures represent the majority of dental trauma in the permanent dentition (26–76% of dental injuries), while crown–root fractures only represent 0.3–5%.

The dentist plays a key role, as the success of treatment and prognosis of the traumatised tooth depends on his accurate diagnosis and treatment procedures.

Crown fractures can be broadly classified as follows:

a) Crown Infraction

In this there occurs a crack of enamel and hence is also termed as “Incomplete fracture”. There is no loss of any tooth substance Enamel/dentine cracks are possible pathways for bacterial penetration into the root canal system of teeth.

The application of dentine bonding agent may help prevent infection of the pulp .

Crown infraction

b) Uncomplicated Crown Fracture

These are fractures confined to enamel OR involving enamel and dentine & there is no pulpal exposure.

Uncomplicated crown fracture

Enamel dentine fracture

c) Complicated Crown Fracture

Fracture involving enamel and dentine AND the pulp is exposed.

Complicated crown fracture

Pulp exposure

Treatment of Crown Fracture

i) Restore fractured portion of tooth

ii) Protect pulp

• If pulp is exposed, we have to do partial pulpotomy or pulpectomy depending on stage of root development

• If pulp is not exposed then indirect pulp capping is done.

iii) Finish off with a composite resin restoration. The final restorative treatment for such teeth is deferred until such time that the pulpal status is clear.

Restoring the Fracture

There are numerous methods of restoring the fracture as listed below.

1) Restoration with fragment.

2) Celluloid crown form.

3) Single build-up with matrix.

4) Layered build-up with matrix or partial crown form.

5) Ceramic Veneers