Minimally Intervention Treatment For Root Fracture With Pulp Exposure

This case report describes a minimal intervention treatment for root fracture with pulp exposure due to a complicated crown-root fracture in a young permanent incisor. An 11-year-old girl presented to the Hospital of Stomatology having suffered an injury to her maxillary right central incisor (tooth #11) 4h. A clinical examination revealed a complicated crown-root fracture with grade I∼II mobility. Electric pulp testing and cold testing revealed a positive response. Radiographic examinations revealed a horizontal the apical one-third fracture. Tooth#11 was treated by partial pulpotomy using iRoot BP Plus (Innovative Bioceramix Inc, Vancouver, Canada) and fragment reattachment. At the 24-month follow-up after treatment, tooth #11 was still vital and functional without clinical and radiographic signs and symptoms. There are limited reports on the treatment of multiple combined tooth fractures which often result in worse outcomes. However, the apparent success was presented in this case by pulpotomy and fragment reattachment. Minimal intervention treatment repaired biological tissues and reduced the risk of pulp infection, thereby creating favorable conditions for root fracture healing. It provides an alternative and effective solution to expensive and complex endodontic and restorative treatments for root fracture with pulp exposure. Minimal intervention treatment with partial pulpotomy and fragment reattachment can be a viable treatment option for root fracture combined with pulp exposure.