Background: Coronal fractures of the anterior teeth are a common form of dental trauma that mainly affects children and adolescents. One of the options for managing coronal tooth fractures when the tooth fragment is available and there is no or minimal violation of the biological width is the reattachment of the dental fragment. Sometimes the reattachment alone does not give favorable esthetic result if a fragment is missing and composite restoration may be combined with reattachment for restoring the crown morphology.
Case description: This case report describes the management of a complicated oblique crown fracture of a maxillary right central incisor. The mobile fractured segment was removed under local anesthesia (LA) and stored in normal saline. Endodontic treatment was given with a master cone size of 50. Reattachment of the tooth fragment was done using the dual-cure resin cement. Access cavity and missing portion of the tooth were restored with composite resin to regain the tooth morphology.
Conclusion: In this case, oblique crown fracture of a young patient was effectively managed with a single-visit endodontic treatment followed by reattachment of tooth fragment. The missing coronal part was restored with composite which gives a better reinforcement to the fractured segment and the remaining tooth structure.
Clinical significance: Reattachment of the tooth is a viable treatment alternative to crowning in anterior tooth trauma for a young patient. It is a viable technique that restores function and esthetics with a very conservative approach and can be considered as a choice when treating a patient with coronal fractures of the anterior teeth especially in a young patient.
Hamilton FA, Hill FJ, et al. An investigation of dento-alveolar trauma and its treatment in an adolescent population. Part 1: the prevalence and incidence of injuries and the extent and adequacy of treatment received. Br Dent J 1997;182:91–95. DOI: 10.1038/sj.bdj.4809313.
Andreasen JO, Andreasen F, et al. Textbook and color atlas of traumatic injuries to the teeth, 3rd ed. St Louis (MO): Mosby; 1994.
Olsburgh S, Jacoby T, et al. Crown fractures in the permanent dentition: pulpal and restorative considerations. Dent Traumatol 2002;18(3):103–115.
Reis A, Francci C, et al. Re-attachment of anterior fractured teeth: fracture strength using different techniques. Oper Dent 2001;26(3):287–294.
Baratieri LN, Ritter AV, et al. Tooth fragment reattachment: an alternative for restoration of fractured anterior teeth. Pract Periodontics Aesthet Dent 1998;10:115–125; quiz 127.
Andreasen FM, Noren JG, et al. Long term survival of fragment bonding in the treatment of fractured crowns. Quintessence Int 1995;26:669–681.
Cavalleri G, Zerman N. Traumatic crown fractures in permanent incisors with immature roots: a follow-up study. Endod Dent Traumatol 1995;11:294–296.
Perdigão J, Lopes M. Dentinbonding State of the art 1999. Compend Contin Educ Dent 1999;20:1151–1162.
Shirani F, Malekipour MR, et al. Hydration and dehydration periods of crown fragments prior to reattachment. Oper Dent 2012;37:501–508. DOI: 10.2341/10-130-L.
Shirani F, Malekipour MR, et al. Effect of storage environment on the bond strength of reattachment of crown fragments to fractured teeth. J Conserv Dent 2011;14:269–272. DOI: 10.4103/0972-0707.85813.
Worthington RB, Murchison DF, et al. Incisal edge reattachment: the effect of preparation utilization and design. Quintessence Int 1999;30:637–643.
Davari AR, Sadeghi M. Influence of different bonding agents and composite resins on fracture resistance of reattached incisal tooth fragment. J Dent 2014;15:6–14.
Bhargava M, Pandit IK, et al. An evaluation of various materials and tooth preparation designs used for reattachment of fractured incisors. Dent Traumatol 2010;26:409–412. DOI: 10.1111/j.1600-9657.2010.00913.x.
Diangelis AJ, Jungbluth M. Reattaching fractured tooth segments: an esthetic alternative. J Am Dent Assoc 1992;123(8):58–63. DOI: 10.14219/jada.archive.1992.0222.
Kumar P, Maheswari U. Reattachment of anterior teeth fragment, an aesthetic alternative: report of a case. J Oral Health Res 2010;1(3):93–96.
Pathan ML, Gaddalay S. Reattachment of anterior teeth fragments: a case report. Int J Appl Dent Sci 2017;3(2):101–103.