An Innovative Method for Fragment Reattachment after Complicated Crown Fracture.

The case of a nineteen-year-old female with atypical fractures to three maxillary incisors (#11 FDI, #8 universal; #21 FDI, #9 universal and #22 FDI, #10 universal) with one showing a complicated crown fracture and pulp exposure is reported. A partial pulpotomy had been carried out immediately after trauma and the patient complained of acute pain on percussion of the left central incisor. Direct restoration with resin-based composite was carried out on the two teeth where fragments were not available (tooth #8 and #10) and root canal treatment with reattachment of fragments and fiber post was carried out on the third (tooth #9). An innovative method was used to reattach the tooth fragments whereby the fiber post was inserted without drilling a hole in the crown thus preserving the integrity of the crown. Follow-up visits confirmed the success of treatment based on clinical and radiographic evaluations. The patient was pain free with no tooth sensitivity and good function and esthetics after four years of follow-up.

CLINICAL SIGNIFICANCE: Case report with a follow-up of 4 years, provides confirmatory evidence of the long-term efficacy of an innovative method to reattach tooth fragments whereby fiber post is inserted without drilling a hole in the crown thus preserving the integrity of the crown. (J Esthet Restor Dent 29:172-177, 2017).