Retrospective evaluation of crown fractures in permanent teeth due to trauma

Traumatic dental injuries (TDIs) are clinical conditions resulting from damage to the teeth and surrounding tissues due to trauma and represent one of the most significant health problems of childhood. Managing these injuries poses challenges for the affected child, parents, and dental professionals. Prompt and appropriate intervention is critical to ensure a favorable prognosis. Delayed or inappropriate treatment may lead to adverse outcomes with esthetic, functional, economic, social, and psychological implications. In this retrospective study, trauma follow-up forms of patients aged 6–16 who presented to our clinic with crown fractures between 2018 and 2024, completed their treatment in our clinic, and attended at least one follow-up visit were examined. The findings were evaluated based on different follow-up intervals: 6–12 months, 12–18 months, 18–24 months, 24–48 months, and over 48 months. The aim of the study was to assess the treatment approaches, pulp survival rates, and long-term follow-up outcomes in these cases. According to the data, the most common cause of trauma was falling (59%), and the most frequently affected teeth were the maxillary central incisors. Injuries most commonly occurred outdoors (41%) and in the spring season (27.8%). The most common treatment modality was direct composite restoration (97.8%) for uncomplicated crown fractures and partial pulpotomy combined with direct composite restoration (57.9%) for complicated crown fractures. Pulp survival varied depending on the treatment type and follow-up period. In teeth treated with direct composite restorations, the pulp survival rate was 85.9%, while it was 84.8% in those treated with partial pulpotomy and direct composite restoration. In cases treated with partial pulpotomy and reattachment, pulp vitality was preserved in 100% of cases. A statistically significant increase in pulp necrosis was observed as the follow-up period extended (p<0.05). In our study, the presence of concomitant luxation negatively affected pulp survival in both uncomplicated and complicated crown fractures, showing a statistically significant correlation (p<0.05). The results emphasize the impact of fracture type, associated injuries, treatment protocol, and long-term follow-up on pulp prognosis. Keywords: Crown fracture; Pulp; Traumatic dental injury