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Fragment Reattachment: A 4-Year Case Report of an Uncomplicated Dental Fracture

Khalid S. Almulhim, BDS, MScD, DScD/Luana Oliveira-Haas, DDS, MS, PhD

DOI: 10.11607/prd.6222

This case report aims to describe a detailed clinical protocol to restore two maxillary central incisors utilizing the crown fragment reattachment technique with adhesive systems and composite resin material. A long-term successful outcome was achieved after 4 years of follow up. Patient presented to the clinic with fracture of the maxillary central incisors. A comprehensive intraoral and radiographic examination revealed that both teeth had extended crown fracture with no pulpal exposure (Class II, Ellis and Davis). Teeth fragments were thoroughly cleaned and inspected before being repositioned. Both fragments were in excellent condition with almost no parts missing. Therefore, the proposed treatment was the fragment reattachment technique. After verifying the position and adaptation fractured fragments, a flowable composite was used to perform the reattachment procedure under rubber dam isolation. With current advancements in Adhesive Dentistry, tooth fragment reattachment, if present in good condition, is considered more conservative option that restores the morphological, esthetic and functional aspects. Although one tooth showed signs of irreversible pulpitis, and needed root-canal treatment 2 weeks after the restoration, the 4-year follow-up visits confirmed the success of the restorative treatment based on clinical and radiographic evaluations. The patient showed good function and esthetic outcomes after four years of follow-up.

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