Abstract

ALVAREZ RODRIGUEZ, Javier; CLAVERA VASQUEZ, Teresita de Jesús  and  CHAPLE GIL, Alain Manuel. Rigid stems, an alternative in the esthetic-functional treatment of apex formation due to complicated crown fracture. Rev Cubana Estomatol [online]. 2016, vol.53, n.1, pp. 93-103. ISSN 1561-297X.

The life periods most commonly affected by complicated crown fractures are childhood and adolescence. The teeth most frequently affected are permanent upper central incisors of incomplete apical formation, resulting in limitations in chewing and speech, as well as psychological effects in adolescence. The treatment consists in the application of an apex formation technique which makes it difficult to also solve the esthetic effect. It was our purpose to describe a case of apex formation in the upper left central incisor, with rigid stem cementation, stump conformation and definitive esthetic and functional restoration. An 8-year-old male patient attends consultation after undergoing dentoalveolar trauma consisting in complicated crown fracture. Radiography revealed slight periodontal expansion and an immature apex. A local anesthetic was applied to perform total pulpal removal of the affected tooth and place intracanal medicament. At the end of the total crown restoration treatment, cementation of a No. 22 rigid stem was performed with type II glass ionomer up to two thirds of the working length, and a hybrid photopolymerizable nanocomposite crown and stump were shaped around it. Evolution was checked every 24 days for three months to verify apical maturation status until total formation was achieved. Rigid stem cementation is an alternative for the functional treatment of apex formation due to complicated crown fracture. It is characterized by a fast, complete recovery of the patient’s oral-dental and psycho-social functions.

Keywords : tooth apex; endodontics; bolt stump technique; dental restoration; dental materials; stem.

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