Restor Dent Endod.  2012 Nov;37(4):240-244.

Considerations during crown reattachment procedure over the pulpal exposure: case report

• Kim B
• Lee Y
• Song MJ
• Shin SJ
• Park JW

Abstract

Crown reattachment is the most conservative treatment which can be used to restore fractured tooth, presumably with sufficient strength, while maintaining original contour, incisal translucency, and reducing chair time and cost. However, in case of crown fracture with pin-point pulp exposure, we should cautiously minimize the irritation to the pulp and consider pre-treatment pulpal status, choice of pulp capping materials, choice of bonding system and treatment sequence during crown reattachment procedures. This case reports the considerations while crown reattachment with direct pulp capping using calcium hydroxide (Dycal, Dentsply Caulk).

Keyword

Crown reattachment; Direct pulp capping; Dycal; Etching; Primer

MeSH Terms

Calcium Hydroxide
Crowns
Dental Pulp Capping
Hydroxides
Minerals
Polymethyl Methacrylate
Tooth
Calcium Hydroxide
Hydroxides
Minerals
Polymethyl Methacrylate

Figure

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  Figure 1 Initial visit. (a) Intraoral photograph (palatal view). Pin-point pulp exposure was seen on tooth #11 and 12; (b) Intraoral photograph (Labial view); (c) Periapical radiograph.

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  Figure 2 After acid etching, Dycal was applied.

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  Figure 3 Labial view after the reattachment was done. The fracture line was visible, but the overcontouring was delayed to reduce the palpal damage.

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  Figure 4 Shade selection was done from cervical and incisal area.

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  Figure 5 Fracture lines were prepared with 0.3 mm depth and 2.5 mm bevel in the incisal-cervical direction.

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  Figure 6 37% Phosphoric acid was applied to the fracture line for 30 seconds.

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  Figure 7 Composite was overcontoured and the excess was removed and polished. (a) Labial view; (b) Palatal view.

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  Figure 8 Immediate postoperative periapical view.

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  Figure 9 14 months after the treatment. (a) Labial view; (b) Palatal view; (c) Periapical view. The teeth had normal pulp and apex and was esthetically acceptable.

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