Treatment of a crown-root fracture with concomitant root fracture

The aim of this case report was to present a treatment strategy for severely injured teeth in children and adolescents by using periodontal surgery and adhesive techniques. A 16-year-old boy presented after a severe bicycle accident. A radiograph revealed a root fracture with connective tissue healing and displacement. Clinically, a crown-root fracture as well as an uncomplicated crown fracture of the same fragment was obvious. The root canal was prepared and filled with gutta-percha to the fracture line. A full periodontal flap was performed, and the crown-root fragment was adhesively fixed. The flap was tightly apposed, and the missing mesial edge of the tooth was restored with composite resin. A control radiograph showed a neatly fixed coronal fragment and sufficient root canal filling. The amount of work required proved to be acceptable for both patient and clinician--even if an implantation might have to be considered when the patient is full-grown--because of the longevity of the procedure.