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Multidisciplinary Management of a Crown-Root Fracture Using Fragment Reattachment
Júlia Vitória Souza de Girão1, Tainah de Oliveira de Rifane1, Cecilia Atem Gonçalves Araújo de Costa1
1Graduate Program in Dentistry, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Objective:
The case report describes conservative multidisciplinary management of a crown-root fracture in the maxillary right central incisor with violation of the supracrestal tissue attachment.
Clinical Considerations:
A 22-year-old patient presented 24 h after dental trauma with pulp exposure and subgingival extension of the fracture line palatally in the maxillary right central incisor. After removal of nonviable palatal fragments, pulpectomy, intracanal medication, and reattachment of the facial fragment were performed under modified rubber dam isolation. The reattachment line was sealed with flowable composite resin, and the palatal wall was reconstructed with composite resin. Cone-beam computed tomography (CBCT) confirmed extension of the fracture to the palatal bone level. After 30 days, endodontic treatment was completed, followed by modified clinical crown lengthening and transsurgical palatal restoration. Esthetic dissatisfaction related to reattachment line was managed by selective facial composite resin addition and esthetic refinement. After 12 months, the tooth remained functional, asymptomatic, periodontally stable, and patient satisfaction with the final esthetic outcome.
Conclusions:
Fragment reattachment combined with endodontic treatment and modified clinical crown lengthening enabled conservative management of the crown-root fracture, preserving tooth structure while restoring function, esthetics, and periodontal stability during the 12-month follow-up.
