Dentin exposure - sealing dentin

Acute treatment includes a seal of exposed enamel dentin with glass ionomer cement.
Treatment options include reattachment of the fragment with composite etch technique if retrieved and found intact. Alternatively, the tooth can be augmented with composite material or a porcelain restoration.

Under emergency settings three treatment options can be considered:

1. Accept the dentin exposure for later restoration.
2. Make a temporary seal with glass ionomer cement (as illustrated).
3. If a fragment is retrieved, bonding of this fragment to the remaining tooth may be performed. If bonding materials are not available, the procedure can be postponed and the tooth fragment stored in saline, for delayed restoration.

Follow-up on tooth vitality is advisable. If pulp vitality is retained at 6 months posttrauma no further follow-up is needed. In case of pulp necrosis, appropriate endodontic therapy has to be implemented.
Temporary or even permanent restoration may be achieved with composite resin augmentation or by replacement of the fragment with composite etch technique. Definitive treatment with porcelain restoration, if needed, should be deferred until termination of patient growth.