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class="entry-title">Restoring a Child’s Smile: The Case of the Broken Incisor and Pulp Vitality Preservation</h1> <p class="post-meta"><a href="https://dentalworld.hu/category/article/" rel="category tag">Article</a></p> </div> <div class="entry-content"> <div class="et-l et-l--post"> <div class="et_builder_inner_content et_pb_gutters3"><div class="et_pb_section et_pb_section_0 et_section_regular" > <div class="et_pb_row et_pb_row_0"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_0 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_image et_pb_image_0"> <span class="et_pb_image_wrap "><img fetchpriority="high" decoding="async" width="1200" height="630" src="https://dentalworld.hu/wp-content/uploads/2018/09/DW-journal-kep.jpg" alt="" title="DW journal kep" srcset="https://dentalworld.hu/wp-content/uploads/2018/09/DW-journal-kep.jpg 1200w, https://dentalworld.hu/wp-content/uploads/2018/09/DW-journal-kep-300x158.jpg 300w, https://dentalworld.hu/wp-content/uploads/2018/09/DW-journal-kep-768x403.jpg 768w, https://dentalworld.hu/wp-content/uploads/2018/09/DW-journal-kep-1024x538.jpg 1024w, https://dentalworld.hu/wp-content/uploads/2018/09/DW-journal-kep-150x79.jpg 150w, https://dentalworld.hu/wp-content/uploads/2018/09/DW-journal-kep-250x131.jpg 250w, https://dentalworld.hu/wp-content/uploads/2018/09/DW-journal-kep-180x95.jpg 180w, https://dentalworld.hu/wp-content/uploads/2018/09/DW-journal-kep-100x53.jpg 100w, https://dentalworld.hu/wp-content/uploads/2018/09/DW-journal-kep-1080x567.jpg 1080w, https://dentalworld.hu/wp-content/uploads/2018/09/DW-journal-kep-600x315.jpg 600w" sizes="(max-width: 1200px) 100vw, 1200px" class="wp-image-8913" /></span> </div> </div> </div> </div><div class="et_pb_section et_pb_section_1 et_section_regular" > <div class="et_pb_row et_pb_row_1"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_1 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_0 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner"><h3 style="text-align: left;">Restoring a Child’s Smile: The Case of the Broken Incisor and Pulp Vitality Preservation</h3></div> </div> </div> </div><div class="et_pb_row et_pb_row_2"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_2 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_1 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner"><p><span style="font-weight: 400;">In a remarkable case of dental repair, a simple yet innovative approach was taken to preserve the vitality of a young patient’s tooth after a fracture exposed the pulp. This case involved an 11-year-old patient with a cleanly broken incisor, presenting a unique challenge and opportunity for dental professionals.</span></p> <p><span style="font-weight: 400;">Reasons for Cementing the Fragment:</span></p> <ul> <li style="font-weight: 400;" aria-level="1"><b>Simple Restoration:</b><span style="font-weight: 400;"> The reattachment of the broken fragment was deemed the most straightforward method to restore both the tooth’s aesthetics and functionality. This is particularly crucial for children, where achieving a color match can be complex.</span></li> <li style="font-weight: 400;" aria-level="1"><b>Durability:</b><span style="font-weight: 400;"> The bond strength obtained through this method is robust, making it more likely that any future trauma would result in a fracture at a new site, rather than a debonding of the repaired fragment.</span></li> <li style="font-weight: 400;" aria-level="1"><b>Biological Potential Preservation:</b><span style="font-weight: 400;"> Compared to alternatives such as endodontic treatments, cementing the fragment maintains the tooth’s biological integrity. Other treatments may be considered if this initial attempt fails.</span></li> </ul> <p><span style="font-weight: 400;">Preserving Tooth Vitality Despite Risks:</span></p> <ul> <li style="font-weight: 400;" aria-level="1"><b>Young Age Consideration:</b><span style="font-weight: 400;"> The decision to prioritize pulp vitality was based on the patient’s age, considering the high potential for recovery and vitality maintenance at a young age. Regular follow-ups are planned to monitor the tooth’s condition, with root canal treatment as a contingency.</span></li> <li style="font-weight: 400;" aria-level="1"><b>Ideal Fit Preservation:</b><span style="font-weight: 400;"> By avoiding a root canal initially, the perfect fit between the tooth and its fragment is maintained, something that might not be achievable post-endodontic treatment.</span></li> <li style="font-weight: 400;" aria-level="1"><b>Future Treatment Options:</b><span style="font-weight: 400;"> Should pulp necrosis occur, root canal treatment is a viable next step.</span></li> </ul> <p><span style="font-weight: 400;">Protocol for Direct Pulp Capping:</span></p> <ul> <li style="font-weight: 400;" aria-level="1"><b>Isolation and Cleaning:</b><span style="font-weight: 400;"> The area is isolated with a rubber dam, and the exposed pulp is cleaned using sodium hypochlorite for its antimicrobial properties, with alternatives like saline solution and chlorhexidine also considered for their respective benefits.</span></li> <li style="font-weight: 400;" aria-level="1"><b>Hemostasis and Drying:</b><span style="font-weight: 400;"> Achieving hemostasis and gentle drying are crucial steps before applying the capping material, ensuring the area is prepared without overdrying.</span></li> <li style="font-weight: 400;" aria-level="1"><b>Direct Pulp Capping:</b><span style="font-weight: 400;"> If the pulp is viable, direct pulp capping is performed using a bioceramic material, chosen for its compatibility and effectiveness.</span></li> </ul> <p><span style="font-weight: 400;">Covering the Bioceramic Material:</span></p> <ul> <li style="font-weight: 400;" aria-level="1"><b>Restoration Options:</b><span style="font-weight: 400;"> The choice between glass ionomer cement and an adhesive protocol is made based on the need for protection and aesthetics. The adhesive protocol, despite its challenges, is selected for its strong bond strength and aesthetic results.</span></li> <li style="font-weight: 400;" aria-level="1"><b>Space Creation:</b><span style="font-weight: 400;"> A small portion of the fragment’s inner surface is removed to accommodate the biomaterial, ensuring a proper fit during reattachment.</span></li> </ul> <p><span style="font-weight: 400;">Practical Application:</span></p> <ul> <li style="font-weight: 400;" aria-level="1"><b>Cementation Process:</b><span style="font-weight: 400;"> The tooth and fragment are prepared with a total etch IV generation adhesive, not immediately polymerized. A preheated sculptable composite is then applied, excess removed, and the assembly is light-cured, following the manufacturer’s instructions meticulously.</span></li> </ul> <p><span style="font-weight: 400;">This case exemplifies how a blend of traditional techniques and innovative materials can result in successful dental outcomes, particularly in preserving the natural vitality and functionality of young patients’ teeth.</span></p> <p></p></div> </div><div class="et_pb_module et_pb_image et_pb_image_1"> <span class="et_pb_image_wrap "><img decoding="async" width="1440" height="1791" src="https://dentalworld.hu/wp-content/uploads/2024/04/The-inital-situation.jpeg" alt="Restoring a Child's Smile: The Case of the Broken Incisor and Pulp Vitality Preservation" title="restoring-a-childs-smile-1.jpeg" srcset="https://dentalworld.hu/wp-content/uploads/2024/04/The-inital-situation.jpeg 1440w, https://dentalworld.hu/wp-content/uploads/2024/04/The-inital-situation-1280x1592.jpeg 1280w, https://dentalworld.hu/wp-content/uploads/2024/04/The-inital-situation-980x1219.jpeg 980w, https://dentalworld.hu/wp-content/uploads/2024/04/The-inital-situation-480x597.jpeg 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) and (max-width: 1280px) 1280px, (min-width: 1281px) 1440px, 100vw" class="wp-image-51499" /></span> </div><div class="et_pb_module et_pb_image et_pb_image_2"> <span class="et_pb_image_wrap "><img decoding="async" width="1440" height="1791" src="https://dentalworld.hu/wp-content/uploads/2024/05/The-broken-fragment.jpeg" alt="Restoring a Child's Smile: The Case of the Broken Incisor and Pulp Vitality Preservation" title="restoring-a-childs-smile-2.jpeg" srcset="https://dentalworld.hu/wp-content/uploads/2024/05/The-broken-fragment.jpeg 1440w, https://dentalworld.hu/wp-content/uploads/2024/05/The-broken-fragment-1280x1592.jpeg 1280w, https://dentalworld.hu/wp-content/uploads/2024/05/The-broken-fragment-980x1219.jpeg 980w, https://dentalworld.hu/wp-content/uploads/2024/05/The-broken-fragment-480x597.jpeg 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) and (max-width: 1280px) 1280px, (min-width: 1281px) 1440px, 100vw" class="wp-image-51500" /></span> </div><div class="et_pb_module et_pb_image et_pb_image_3"> <span class="et_pb_image_wrap "><img decoding="async" width="1440" height="1791" src="https://dentalworld.hu/wp-content/uploads/2024/05/The-pulp-exposure.jpeg" alt="Restoring a Child's Smile: The Case of the Broken Incisor and Pulp Vitality Preservation" title="restoring-a-childs-smile-3.jpeg" srcset="https://dentalworld.hu/wp-content/uploads/2024/05/The-pulp-exposure.jpeg 1440w, https://dentalworld.hu/wp-content/uploads/2024/05/The-pulp-exposure-1280x1592.jpeg 1280w, https://dentalworld.hu/wp-content/uploads/2024/05/The-pulp-exposure-980x1219.jpeg 980w, https://dentalworld.hu/wp-content/uploads/2024/05/The-pulp-exposure-480x597.jpeg 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) and (max-width: 1280px) 1280px, (min-width: 1281px) 1440px, 100vw" class="wp-image-51501" /></span> </div><div class="et_pb_module et_pb_image et_pb_image_4"> <span class="et_pb_image_wrap "><img decoding="async" width="1440" height="1791" src="https://dentalworld.hu/wp-content/uploads/2024/05/Pulp-caping-with-bioceramic.jpeg" alt="Restoring a Child's Smile: The Case of the Broken Incisor and Pulp Vitality Preservation" title="restoring-a-childs-smile-4.jpeg" srcset="https://dentalworld.hu/wp-content/uploads/2024/05/Pulp-caping-with-bioceramic.jpeg 1440w, https://dentalworld.hu/wp-content/uploads/2024/05/Pulp-caping-with-bioceramic-1280x1592.jpeg 1280w, https://dentalworld.hu/wp-content/uploads/2024/05/Pulp-caping-with-bioceramic-980x1219.jpeg 980w, https://dentalworld.hu/wp-content/uploads/2024/05/Pulp-caping-with-bioceramic-480x597.jpeg 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) and (max-width: 1280px) 1280px, (min-width: 1281px) 1440px, 100vw" class="wp-image-51502" /></span> </div><div class="et_pb_module et_pb_image et_pb_image_5"> <span class="et_pb_image_wrap "><img decoding="async" width="1440" height="1791" src="https://dentalworld.hu/wp-content/uploads/2024/05/Checking-the-fit-prior-to-cementation.jpeg" alt="Restoring a Child's Smile: The Case of the Broken Incisor and Pulp Vitality Preservation" title="restoring-a-childs-smile-5.jpeg" srcset="https://dentalworld.hu/wp-content/uploads/2024/05/Checking-the-fit-prior-to-cementation.jpeg 1440w, https://dentalworld.hu/wp-content/uploads/2024/05/Checking-the-fit-prior-to-cementation-1280x1592.jpeg 1280w, https://dentalworld.hu/wp-content/uploads/2024/05/Checking-the-fit-prior-to-cementation-980x1219.jpeg 980w, https://dentalworld.hu/wp-content/uploads/2024/05/Checking-the-fit-prior-to-cementation-480x597.jpeg 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) and (max-width: 1280px) 1280px, (min-width: 1281px) 1440px, 100vw" class="wp-image-51503" /></span> </div><div class="et_pb_module et_pb_image et_pb_image_6"> <span class="et_pb_image_wrap "><img decoding="async" width="1440" height="1791" src="https://dentalworld.hu/wp-content/uploads/2024/05/Immediately-after-the-cementation.jpeg" alt="Restoring a Child's Smile: The Case of the Broken Incisor and Pulp Vitality Preservation" title="restoring-a-childs-smile-6.jpeg" 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