An Unusual Primary Molar Pulpotomy

This case report documents the step-by-step repair of a fractured maxillary right primary first molar in a 6-year-old girl. She had been playing "cops and robbers" in her home when she fell on her face, striking and cutting her chin. After the chin laceration was sutured at a local hospital emergency room, the patient was brought to the dental office to have her teeth evaluated for injuries. The blow to her chin had crunched the posterior mandibular teeth against the opposing maxillary posterior teeth. As a result, the buccal aspect of her maxillary right primary first molar was sheared subgingivally, but still in place, and the pulp chamber was exposed. The mesiobuccal cusp of the adjacent primary second molar was also struck, and it demonstrated evidence of an internal craze fracture. Following pulpotomy and restoration of the fractured tooth with a stainless steel crown, the patient was followed for 3 years and 11 months, with no further treatment needed, until the tooth was extracted at the request of her orthodontist. The second molar with the craze-fractured cusp was closely monitored but required no treatment until it exfoliated.

Theodore P. Croll, DDS
Clinical Professor
Case Western Reserve University
School of Dental Medicine
Cleveland, Ohio
Adjunct Professor of Pediatric Dentistry
University of Texas Health
Science Center at San Antonio
School of Dentistry
San Antonio, Texas
Clinic Director
Cavity Busters Doylestown
Doylestown, Pennsylvania

Kevin J. Donly, DDS, MS
Diplomate
American Board of Pediatric Dentistry
Professor and Chair
Department of Developmental Dentistry
University of Texas Health
Science Center at San Antonio
School of Dentistry
San Antonio, Texas