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. 2025 Mar 17;13(3):e70332.
doi: 10.1002/ccr3.70332. eCollection 2025 Mar.

Management of a Complex Crown-Root Fracture in a Single Appointment Through Root Canal Therapy and Rebonding

Affiliations

Management of a Complex Crown-Root Fracture in a Single Appointment Through Root Canal Therapy and Rebonding

Mohammed H AbdElaziz et al. Clin Case Rep. .

Abstract

A 10-year-old male presented with a mobile and fractured maxillary right central incisor following dental trauma. Clinical and radiographic examinations revealed a chisel-type crown-root fracture with supragingival labial and subgingival palatal extensions. A direct crown reattachment was planned, emphasizing biological width preservation. After removing the coronal fragment, endodontic treatment was performed using a rotary file system and was obturated with a bioceramic sealer. A fiber post was selected and integrated into the fractured fragment, which was reattached using resin cement. Additionally, a gingivectomy was performed to enhance margin visibility and restore biological width. The adjacent left central incisor was treated for an uncomplicated crown fracture using follow-up evaluations over 12 months revealed stable fragment reattachment, good periodontal health, and restored aesthetics and function. A custom mouthguard was provided to prevent future trauma. This case highlights the efficacy of a multidisciplinary approach combining endodontic, restorative, and periodontal techniques for managing crown-root fractures, achieving favorable long-term outcomes in pediatric patients.

Keywords: biological width; crown reattachment; crown‐root fracture; fiber post.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Preoperative clinical photos and radiograph. (A) Frontal view. (B) Maxillary occlusal view. (C) Preoperative periapical radiograph.
FIGURE 2
FIGURE 2
Measuring the biological width by using the periodontal UNC‐15 probe.
FIGURE 3
FIGURE 3
(A) Fractured coronal fragment. (B) Stored the fragment in a saline solution.
FIGURE 4
FIGURE 4
(A) Maxillary occlusal view. (B) Master cone fit. (C) Obturation with post space. (D) Post fit.
FIGURE 5
FIGURE 5
Fractured segment. (A) Opening the access through the fractured segment. (B) Insert the fiber post through the fractured segment.
FIGURE 6
FIGURE 6
(A) Maxillary occlusal view. (B) Frontal view.
FIGURE 7
FIGURE 7
(A) Gingivectomy by using blade no. 12. (B) after removing 2 mm of soft tissue.
FIGURE 8
FIGURE 8
Etching the fractured fragment.
FIGURE 9
FIGURE 9
Post‐operative clinical photos and radiograph (A) Frontal view after cementing the fractured fragment. (B) Frontal view after restoring tooth #21 by resin‐bonded composite restoration. (C) Periapical radiograph after cementation.
FIGURE 10
FIGURE 10
Clinical photos after placement of sporty mouth guard.
FIGURE 11
FIGURE 11
Post‐operative clinical photos and radiograph. (A) Frontal view after 12 months. (B) Periapical radiograph after 6 weeks. (C) Periapical radiograph after 12 months.

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