抄録
We experienced 13 children (10 boys and 3 girls) with ages ranging from 8 years 2 months to 14 years 8 months, for a total of 15 traumatized teeth, who visited Department of Pediatric Dentistry, Iwate Medical University Hospital, with a chief complaint of traumatic crown fracture of permanent incisors, during the period of May 1984 to May 1992. These children were treated by reattaching the original fragments with adhesive composite resin. These cases were followed clinically and radiographically after treatment. The injured tooth was the upper central incisor in most cases and was the lower central incisor in one case only. Prior to reattachment of fragments, indirect pulp capping was performed on 9 teeth, partial pulpotomy on 4 teeth, and extirpation of pulp on 2 teeth. We used chemically-cured adhesive composite resins (Clearfil posterior®, Microrest® and Panavia®) to reattach the fragments. The treatments were performed according to Ellis and Davey's classification. In the cases of class 1 (mild fracture of the crown), the sharp edges in the fracture area were smoothed. This was followed by etching the tooth and fragments, and then, reattaching the fragments to the tooth using an adhesive composite resin. In cases of class 2, indirect pulp capping was performed, using calcium hydroxide preparation Dycal®. This was followed by a pretreatment similar to the class 1 cases, and finally by reattachment of the fragments. In cases of class 3.2, partial pulpotomy was performed using a calcium hydroxide preparation Calvital®, followed by reattachment of the fragments. During follow-up period (ranged from 1 year 10 months to 9 years and 10 months after the treatment), in 5 cases, the reattached fragments became detached due to additional trauma, but in no case was the fragment displaced spontaneously. In cases where pulp capping or partial pulpotomy was performed, tooth root formation was completed, leading to favorable results. This technique requires only a relatively small amount of the tooth to be shaved away and restores sufficient strength to enable a smooth return to daily eating habits, it therefore provides a useful means of treating crown fractures of young permanent incisors.
