Tooth Fragment Reattachment following Crown Root Fracture: A Case Report

Abstract

A 32-year-old man presented with a complicated crown-root fracture of a maxillary lateral incisor. The fracture extended subgingivally, and apical to the alveolar bone crest, invading the biologic width. Flap surgery to expose the fractured root face was performed and the coronal tooth fragment reattached with a dual-cure resin adhesive. Examination six months after treatment revealed periodontal health, good aesthetics and normal function.

Fragment reattachment after complicated crown‐root fractures of anterior teeth: A systematic review

“…Three articles did not mention the gender of the patient 13,16,22 12,13,22–26 two each from Turkey 15,27 and Brazil 14,16 and one each from Portugal, 28 Bangladesh, 10 and Malta 29 (Table 4).…”

“…Out of a total of 19 teeth assessed, 15 were maxillary central incisors and the remaining four were maxillary lateral incisors. Tooth mobility and percussion tests were used as diagnostic tests in six 13,15,22,25,28,29 and two articles, 13,29 respectively. In ten of the included articles, only a single straight angled pre‐operative intra‐oral periapical (IOPA) radiograph was taken for the assessment of the extent of fracture 10,12–15,22–25,27 .…”

“…With regard to the exposure of the fracture, the following procedures were done: mucoperiosteal flap surgery in eight articles, 10,14–16,24,26,28,29 mucoperiosteal flap surgery with osteoplasty and osteotomy in five articles, 10,15,16,28,29 and only gingivectomy in four articles 12,15,23,25 . However in three articles, exposure of the fracture was not done 13,22,27 …”

Adhesive tooth fragment reattachment with intentional replantation: 36‐month follow‐up

“…Various treatment strategies such as removal of the fragment and restoring the tooth with resin composites or full crown restorations, orthodontic or surgical extrusion of the fragment and restoration of the tooth were described in the literature including intentional replantation of the crown-root-fractured tooth which we preferred in this case (2)(3)(4)(5)(6)(7)(8)12). Intentional replantation must be accurately planned to avoid the periodontal ligament cell loss.…”

“…The development of adhesive technologies has made it possible to reattach the fragment if it is available (8)(9)(10). This could be a more conservative approach and have several advantages, such as a better aesthetic result that became an important criterion for patients and also dentists in recent years, incisal margin wear that matches that of adjacent teeth, patient acceptance and a faster and cheaper procedure (9,11,12). However, in cases of deep located fractures, the presence of gingival suppuration and bleeding compromises the success of the endodontic and adhesive procedures.…”