Which tooth is most commonly associated with complicated crown fractures?

• A. Maxillary premolar 4
• B. Mandibular incisor 3
• C. Maxillary canine
• D. Mandibular premolar 1

Answer: (A)

Complicated crown fractures happen when the fracture line reaches the pulp, so the tooth most likely to show this pattern is one where a traumatic crack can easily extend to the pulp. The maxillary first premolar has a prominent buccal cusp that often bears direct force during trauma, and in many patients the dentin near the pulp is relatively thin—especially in younger individuals—so a fracture that propagates through enamel and dentin is more likely to expose the pulp. This combination makes the maxillary first premolar the tooth most commonly associated with a complicated crown fracture among the options.