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The present investigation evaluated the prognosis for vitality after an acute trauma in 3144 permanent incisors with enamel-dentin fracture as the only damage and in 923 incisors with enamel-dentin fracture combined with other symptoms on the damaged tooth. The teeth were examined at regular intervals. The observation time was more than 2 years in the case of 78.9% of the material. Pulpal necrosis developed in 250 teeth (6.1%). Pulp death occurred in 3.2% of teeth with enamel-dentin fracture as the only damage. The combination of enamel-dentin fracture and concussion resulted in pulpal necrosis in 5.8% and cases involving both concussion and mobility showed pulpal necrosis in 30.1% of teeth. A registration of the enamel-dentin fracture based on the extent of dentin exposure was undertaken. The relationship between extent of dentin exposure and pulpal necrosis as well as influence of treatment on pulpal necrosis was clearly illustrated. It is concluded that information on damage to the mineralized tissue without details of damage occurring at the same time to supportive tissue is of doubtful value in assessing the prognosis.

The frequency and type of developmental disturbances in the permanent teeth in relation to the child's age at the time of injury were examined in 78 patients with 100 intruded primary incisors. The central incisors were found to be the most frequently affected teeth. Only maxillary teeth were involved. The dominating age group was 1-3 years and intrusion was seldom seen after the age of 4 years. The frequency of disturbed normal development of the permanent teeth was 54%. In eight cases the intruded teeth were removed immediately, 86 teeth reerupted, and six teeth did not reerupt. Internal white enamel hypoplasia was seen frequently; external hypoplasia, seldom.

The frequency and type of developmental disturbances in the permanent teeth in relation to the patient's age at the time of injury were examined in 77 patients with 85 exarticulated primary incisors. The central incisors are the most frequently affected teeth and injuries occur more often to teeth on the right than on the left side. The frequency of disturbed normal development of the permanent teeth was 74.1% for the total material. From 0-2 years the frequency is 94.5% and after the age of 5 years the frequency is only 18.2%. External enamel hypoplasia is the more common result in patients whose trauma occurred when they were less than 3 years old, whereas internal enamel hypoplasia is the unsual result of traumas occurring after the age of 3 years.

The present investigation evaluated the prognosis for vitality after an acute trauma in 2891 permanent incisors with enamel fracture as the only damage, and in 476 incisors with enamel fracture combined with other symptoms on the damaged tooth. Pulpal necrosis developed in 57 teeth (1.7%). Acute treatment in connection with enamel fracture was only performed in half of the cases and had no importance on vitality. The combination of enamel fracture and concussion or mobility resulted in pulpal necrosis in 8.5% of cases, and cases involving both mobility and concussion meant pulpal necrosis in 14% of teeth. The findings clearly illustrated that an enamel fracture is an injury with an extremely favorable prognosis, and that the risk group can be narrowed to cases of combined injuries involving the supportive tissue.

Complicated fractures occur in 3.5% of acute traumatized incisors. A pulp exposure results in almost all cases in endodontic treatment. The present investigation evaluated the prognosis for the different types of endodontic treatments following complicated crown fractures. Only incisors with an observation period of more than 23 months are included; the material comprises 301 incisors. Pulp capping was successful in 90.5% of the cases. There was a clear tendency for a positive correlation between the stage of the root development and the success rate of the endodontic treatment. In cases with pulpotomy ZnO/eugenol cement or calcium hydroxide was used as amputation material. The pulp reactions following the different treatments are discussed. If calcium hydroxide was used 90% was successful, while in cases with ZnO/eugenol cement as amputation material 8.9% developed necrosis of the pulp and 34.4% showed an undesirable reaction with formation of hard tissue barrier or obliteration. The healing frequency was 83.9% for teeth treated with pulpectomy but there was a clear correlation between the standard of the root filling and the success rate. For all three treatment groups there was a correlation between damage to the supportive tissue and treatment success.