From Horizontal Root Fracture to Implant Rehabilitation: A Case Report

Traumatic crown-root fractures involving previously endodontically treated anterior teeth can present substantial restorative difficulties, particularly when the fracture line extends below the alveolar crest and compromises the remaining tooth structure. Preservation of the alveolar ridge following extraction is essential to facilitate future implant-supported rehabilitation and optimize aesthetic outcomes. This report describes the management of a 17-year-old male who presented with pain and mobility of the maxillary right central incisor following dental trauma. The tooth had undergone prior root canal treatment but lacked a definitive coronal restoration. Clinical and radiographic evaluation revealed a horizontal crown-root fracture extending subcrestally, accompanied by a defect in the labial cortical plate. Owing to the unfavorable restorative prognosis, limited residual tooth structure, and inability to establish a predictable ferrule, the tooth was considered nonrestorable and extracted atraumatically. Socket preservation was performed using sticky bone prepared from injectable platelet-rich fibrin, advanced platelet-rich fibrin, and xenograft particles, followed by provisional rehabilitation with a Maryland bridge. Radiographic assessment after three months demonstrated adequate preservation of ridge architecture, permitting placement of a 3.5 × 13 mm dental implant with simultaneous guided bone regeneration. Definitive prosthetic rehabilitation was subsequently completed. This case highlights the potential benefit of combining autologous platelet concentrates with xenograft material for ridge preservation after the extraction of nonrestorable traumatized teeth, thereby supporting predictable implant placement and favorable functional and aesthetic outcomes in adolescent patients.