MANAGEMENT OF COMPLICATED...

Patient came with chief complaint of broken upper front teeth due to fall on face while playing at school 10 days back. No h/o retrieval of broken teeth fragments. H/0 soft tissue swelling following trauma towards which analgesics & antibiotics were prescribed by their family dentist. Unable to eat from front teeth due to pain on biting & severe sensitivity to hot & cold foodstuffs.

O/E:11,21- complicated crown fracture with exposed pulp. No pathologic mobility No pain on percussion. Heat test- positive Cold test- positive

Radiographic examination showed Mesioangular fracture line involving enamel, dentin & pulp. Normal root morphology & NAD with periapical apparatus.

Dx: 11,21- complicated crown fracture with reversible pulpitis

Treatment plan: 11,21- vital pulp therapy ( Cvek’s pulpotomy /complete cervical pulpotomy) followed by composite built up of the broken fragment. Periodic follow up visits at 4 weeks, 8 weeks, 6 month & 1 year.

11,21- Access opening done through the exposure site to preserve as much tooth structure as possible. Looking at the pulp status clinically decision was made to do complete pulpotomy using NaOCl followed by immediate placement of MTA (Angelus) over the root stumps. RM-GIC was placed as a post pulpotomy restoration .