Reattaching fractured tooth fragments. The composite rod technique (CRT)

Traumatic dental injury (TDI) involves coronal fractures of the maxillary anterior teeth, a relatively frequent occurrence in children and adolescents. The location in the arch of the maxillary incisors makes them precariously vulnerable to external trauma that requires immediate attention, not only to pacify the emotional anguish of the patient and parents, but also to safeguard the structural integrity of these pivotal teeth that are the cornerstone of dental esthetics. Restitution of TDI is particularly challenging if a patient presents with pulp involvement or vertical root fractures, necessitating both endodontic and restorative intervention or possibly extraction. The key elements for therapy are accurate diagnosis and expediency to alleviate pain, placate psychologic shock, and mitigate social embarrassment due to compromised esthetics. The latter is particularly significant for young patients who may encounter insensitive peer taunting that affects their mental well-being. This article focuses on the work steps for reattaching fractured tooth fragments isolated to enamel and dentin, including those involving the pulp, with a novel, minimally invasive approach called the composite rod technique (CRT) for facilitating the relocation of the fragment, optimizing fracture resistance of the fragment-abutment complex, and restoring anterior esthetics.