Fragment reattachment in uncomplicated crown fracture: a case report

Abstract

Introduction: Dentoalveolar trauma in school-aged children is a frequent emergency in pediatric dental practice. Among these injuries, uncomplicated crown fractures of the permanent maxillary incisors are highly prevalent, with significant esthetic and emotional impact. When clinical conditions allow, the reattachment of the original tooth fragment represents a conservative, functional, and psychologically favorable alternative. Objective: To describe the clinical case of a pediatric patient in whom a crown fragment was reattached following an uncomplicated crown fracture of the left maxillary central incisor (tooth 2.1). Case Report: A 10-year-old male patient presented to the Dental Clinic of Universidad Andrés Bello (Chile) after a fall at home. The tooth fragment was preserved in a moist environment. Clinical and radiographic examination revealed a contused-lacerated wound on the upper lip, subluxation with enamel fracture of tooth 1.1, and an uncomplicated enamel-dentin crown fracture of tooth 2.1. The fragment was hydrated in saline solution and an internal groove was prepared to improve retention. Under local anesthesia, an adhesive protocol was applied to both the fragment and the remaining tooth structure. The fragment was reattached using flowable and composite resin under relative isolation. Conclusion: Fragment reattachment is a minimally invasive restorative option that offers esthetic, functional, and psychological benefits. Its success relies on timely diagnosis, proper handling of the fragment, and appropriate use of adhesive materials. This approach is especially recommended in growing patients due to its conservative nature.