Management of a complicated crown-root fracture in a young permanent incisor using intentional replantation

The purpose of this case presentation is to review the rationale for and illustrate the clinical procedures involved in intentional replantation of a maxillary central incisor following a complicated crown-root fracture. The treatment of complicated crown-root fractures in children often is compromised by a fracture below the gingival margin and/or bone. This makes isolation difficult and comprises the hermetic seal that is critical for a successful endodontic treatment. Orthodontic or surgical extrusion with gingivectomy has been suggested; however, these approaches can be expensive, time-consuming, esthetically compromising, and unsatisfactory when the fracture line is deep below the gingiva. Our presentation will discuss the treatment options for such cases and introduce the concept of intentional replantation as an option to manage complicated crown-root fractures in young permanent anterior teeth.