Abstract
Anterior teeth with subgingival fractures require a complex treatment plan that addresses biologic, functional and aesthetic factors. This case report describes the management of a crown-root fractured maxillary left central incisor. An interdisciplinary approach was used to restore the tooth due to the complex nature of the treatment. Orthodontic extrusion was performed to move the fracture line above the alveolar bone and periodontal surgery to recontour the altered gingival margin. Finally, the incisor was restored performing a root canal retreatment with a fiber post and a full ceramic crown. The treatment resulted in secured periodontal health and good aesthetics. Key words:Crown-root fracture, orthodontic extrusion, crown lengthening, root canal retreatment, full ceramic crown.
Highlights
Crown-root fractures involve enamel, dentine and/or pulp and comprise up to 5% of all traumatic injuries
Invasion of biological width by fracture line presents a clinical challenge in restorative planning [1] and may require a combination of endodontic, periodontal, orthodontic and restorative procedures
Indication of the type of treatment depends on the amount of remaining tooth structure and level of the fracture line [2]
Summary
Crown-root fractures involve enamel, dentine and/or pulp and comprise up to 5% of all traumatic injuries. Invasion of biological width by fracture line presents a clinical challenge in restorative planning [1] and may require a combination of endodontic, periodontal, orthodontic and restorative procedures. Extraction, surgical crown lengthening, surgical extrusion and orthodontic extrusion are possible treatment options for a fractured tooth involving the biologic width.
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