Management of Ellis Class II Fracture in Young Permanent Maxillary Central Incisor
DOI:
https://doi.org/10.30649/denta.v18i2.5Keywords:
Composite Resin, Oral Trauma, Tooth FractureAbstract
Background: Tooth fracture is a condition of missing or lost fragments of a complete tooth. Tooth fracture usually occurs simultaneously with another oral injury. Objective: This case report discussed the management of Ellis class II fractures on an immature permanent central incisor of a patient who reported to Jenderal Achmad Yani University (Unjani) Dental Hospital. Case: An 11-year-old girl revealed a broken upper left tooth, sensitive to cold drinks that interfered with her appearance one year ago. The patient had a good general condition, no abnormalities during an extraoral examination, and a history of pain on the lower back tooth since a year ago. Case Management: Management of Ellis class II fracture in young permanent central incisor was conducted by using a class IV composite resin restoration. Conclusion: The management of Ellis class II fracture should be conducted holistically and systematically with subjective, intraoral, extraoral, and adjunctive examinations which should be performed correctly and considering the child’s psychology.
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References
Grace, Santo & Ramachandran, Lakshmi & Karthikeyan, Janani & Shankar, Sindhuja. (2022). Trauma and the Periodontal Tissues: A Narrative Review. 10.5772/intechopen.108202.
Levin L, Peter FD, Lamar H, Anne O’Connell, Ashraf FF, Cecilia B, Paul VA. International Association of Dental Traumatology Guidelines for the Management of Traumatic Dental Injuries: General Introduction. Dent Traumatol. 2020; 36(4):309-313. DOI: https://doi.org/10.1111/edt.12574
Almulhim B. Knowledge and Awareness of School Teachers Regarding Emergency Management of Tooth Avulsion in the Kingdom of Saudi Arabia: A Cross-Sectional Study. The Open Dentistry Journal. 2022; 16: 1-7. DOI: 10.2174/18742106-v16-e2112231.
Djemal S, Mohammadreza A, Aviva P, Nectaria P, Edward B, and Sadia N. Traumatic dental injuries in adults attending a London-based trauma clinic in the UK: a seven-year survey. British Dental Journal; 233 (12): 1022-1028. DOI: https://doi.org/10.1038/s41415-022-5313-4.
Punati Nithin, Adrij Dutta, Kiran Kumar HC, K. Sadashiva Shetty, Sapna B. Prevalence of incisal trauma in class II division 1 malocclusion compared to class I control group – a retrospective study. International Journal of Contemporary Medical Research 2020; 7(12): L12-L16.
Bagde R, Rasik B, Dipooja P, Anamika S, and Smita W. Fractured Anterior Tooth Fragment Reattachment: A Case Report. J Res Adv Dent. 2019; 9 (3s): 175-182.
Abdullah MI, Lamia IS, and Abdul NHW. Dental Trauma among School Children at Age 7-12 Years in Fallujah City, Anbar Governorate, Iraq. International Medical Journal. 2018; 25 (5): 340 – 342.
Khandelwal D, Namita K, Rishi T, Amit K, and Padma Y. Prevalence of dental trauma in permanent anterior teeth in 6-12-year-old children in school going children of East Delhi. Int J Contemp Pediatr. 2023; 10(12): 1832-1836. DOI: https://dx.doi.org/10.18203/2349-3291.ijcp20233605.
Apponi, R.; Murri dello Diago, A.; Colombini, V.; Melis, G. Direct versus Indirect Techniques to Manage Uncomplicated Crown Fractures of Anterior Teeth Following Dentoalveolar Trauma. Dent. J. 2021; 9: 13. https://doi.org/10.3390/dj9020013
Saraswathi S, Kumar R. P. Prevalence of Permanent Anterior Teeth Trauma in Children Between 8-12 Years in Urban and Rural Districts in Rohtak, Haryana, India. Biomed Pharmacol J 2018;11(1). DOI: https://dx.doi.org/10.13005/bpj/1396
Jeffrey, Meliawaty F, Djohan FS. Emergency management of dental trauma in children's dental avulsion cases. Makassar Dental Journal April 2024; 13(1): 96-99, p-ISSN:2089-8134, e-ISSN:2548-5830. DOI 10.35856/mdj.v13i1.836.
Mat Zainal MK, Abdullah D. Re-attachment of a Fractured Maxillary Central Incisor: A Case with Two Years Follow-up. Iran Endod J. 2021;16(2):131-136. doi: 10.22037/iej.v16i2.25939. PMID: 36704216; PMCID: PMC9709891.
Myers GL. Evaluation and diagnosis of the traumatized dentition. Dent Traumatol. 2019 Dec;35(6):302-308. doi: 10.1111/edt.12498. Epub 2019 Oct 14. PMID: 31177614.
Arroyo Bote S, Bennasar Verges C, Ribas-Perez D, Rodriguez Menacho D, Villalva Hernandez-Franch P, Barbero Navarro I, Castaño Séiquer A. Complications Arising from Dental Trauma Incurred from Falls Involving Geriatric Patients: A Case Report. Diagnostics. 2023; 13(19):3021. https://doi.org/10.3390/diagnostics13193021
Fu X, Kim HS. Dentin Mechanobiology: Bridging the Gap between Architecture and Function. International Journal of Molecular Sciences. 2024; 25(11):5642. https://doi.org/10.3390/ijms25115642
Widya Nugrohowati, C., Hadriyanto, W., & Nugraheni, T. Direct Composite Resin Restoration of Anterior Maxillary Teeth and Esthetic Smile Design: A Case Report. J Dent Indones. 2020;27(2): 103-108
Dedgaonkar, A. K., Patel, A. R., Jajoo, S. S., Shah, R., Shah, P., & Choudhary, S. (2022). Comparative evaluation of impact strength of natural tooth and two different fragment reattachment technique: An in-vitro study.International Journal of Health Sciences,6(S10), 1414–1426. DOI: https://doi.org/10.53730/ijhs.v6nS10.14030.
Cho K, Ginu R, Paul F, Leon P, and Gangadhara P. Dental Resin Composites: A Review on Materials to Product Realizations. Composites Part B Engineering. 2021; 230 (1):109495.
Lakshmi SBS, Lakshmanan L. Association of Ellis Class 2 fracture in 13-17 years old children. J Adv Pharm Technol Res. 2022 Nov;13(Suppl 1):S26-S30. doi: 10.4103/japtr.japtr_125_22. Epub 2022 Nov 30. PMID: 36643128; PMCID: PMC9836121.
American Academy of Pediatric Dentistry. Guidelines for the Management of Traumatic Dental Injuries: 1. Fractures and Luxations of Permanent Teeth. 2013; (6): 2-12.
Hamed Alanazi, M., Ibrahim Barnawi, N., Ahmed Almohaimel, S., Awadh Almutairi, M., Khalaf Alanezi, O., Ali Al bassry, A. and et al. Evaluation of Dental Pulp Testing: Simple Literature Review. Arch Pharma Pract 2019;10(3):37-9
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