Case 10: A 25 years old healthy patient presented in the clinic for extraction of tooth #28. You heard a sound of fracture during extraction. What 's the possible diagnosis? How do you confirm the diagnosis? Discuss management. There are multiple possible causative factors for the fracture to happen in different places. Crown fracture can happen due to weakened crown caused by large carious lesion, smaller bulk of the crown, abnormal root form and an impatient or frustrated dentist might have applied heavy forces with the forceps. As it happens even to the most skilled dentists, it shouldn 't be thought of as a disaster. Dentist should not proceed with extraction and must assess the situation. Whether to proceed with the extraction or not depends on many factors including how extensive the fracture is or if there is adequate or insufficient access to the root to grasp the tooth firmly. Referral to an oral surgeon might be necessary for trans-alveolar removal of the fractured crown. …show more content…
Horizontal or vertical, the case should be diagnosed by the dentist. If the root was loosened and is movable or not in close proximity to the maxillary antrum, it can be removed using elevators such as Cryer elevator. If the root cannot be removed using intra-alveolar technique for one of the stated reasons or any other reason, a flap providing adequate access to the root area should be made by the oral surgeon and trans-alveolar removal is necessary. However, if the tooth pulp was vital and is smaller than 5mm in diameter, it can be left in