Document Type : Case Report
Authors
Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences (ABSMIDS), Department of Conservative Dentistry and Endodontics, Mangalore, Karnataka, India
Abstract
Background: Complicated crown–root fractures present a clinical challenge due to fracture depth, biological width involvement, and the condition of the coronal fragment. Fragment reattachment is a conservative, biologically driven option that preserves natural esthetics and tooth structure while minimizing biological width violation. When the fractured segment is intact and retrievable, reattachment offers rapid functional and esthetic restoration with reduced procedural complexity. Successful outcomes depend on careful case selection, patient compliance, and a clear understanding of treatment limitations.
Case Report: A 25-year-old male presented with a complicated crown–root fracture of the maxillary left lateral incisor following trauma. The oblique fracture extended 2 mm apical to the palatal gingival margin with pulpal exposure, while the coronal fragment remained intact. Gingivectomy using a diode laser exposed the fracture margin for proper adaptation. Due to prolonged pulpal exposure, root canal treatment was performed. A fiber-reinforced post was placed as an intra-radicular splint to support the weakened structure and facilitate fragment stabilization. The corresponding space within the fragment allowed the post to be fully seated. Both the tooth and fragment were etched, bonded, and reattached using flowable resin cement, followed by composite restoration of the buccal margin.
Conclusion: Fiber-post-supported fragment reattachment provides a conservative and esthetic management option for complicated crown–root fractures while preserving periodontal health and tooth integrity. The 5-year follow-up demonstrated maintained function, stability, and esthetics, supporting fragment reattachment as a predictable first-line treatment when the fractured segment is intact and suitable for reattachment.
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