Management of permanent incisors with complicated crown fracture by MTA pulpotoy

Introduction: Complicated crown fractures involve enamel, dentin, and pulp and occur in 0.9 to l3% of all dental injuries. If left untreated, will always result in pulp necrosis but, if it handled correctly, prognosis of the pulp following a traumatic crown fracture can be favorable. Case Report: The present case report describes an apexogenesis report of a 9-year old boy referred to department of Endodontics 4 days after an impact trauma to the maxillary right central and lateral incisor that caused a complicated crown fracture and pulpal exposure. In the radiographic examination, the tooth was observed to be immature. After access cavity preparation, cervical pulpotomy was performed, and the remaining pulp was capped with mineral trioxide aggregate (MTA) cement. The crown was restored by composite on the next day. The radiographic and clinical examinations on the 18-month follow ups showed that the tooth remained functional, root development was completed, and the apex was formed. No further endodontic intervention was necessary. Conclusion: MTA pulpotomy is an effective treatment in maintaining pulpal vitality and allowing physiological root development.