Clinical Approach of Permanent Maxillary Incisor with Complicated Crown-root Fracture Through Intentional Replantation

Jaime Díaz M.; Viviana Barrera O.; Alejandra Jans M. & Carlos Zaror S.

Summary

Crown root fracture management is a clinical and interdisciplinary challenge, either in its initial emergency care as in the definitive treatment planning and execution. Three main treatment alternatives are described: surgical and orthodontic extrusion of crown-root remnant, gingivectomy and intentional reimplantation, depending on factors such as: age of patient, clinical conditions of periodontal ligament and root length. This paper reports a clinical case of an adhesive fragment reattachment in a complicated crown root fracture in upper maxillary central incisor through intentional replantation. A 10 year-old male patient with complex dentoalveolar trauma, which highlights a complicated crown root fracture on tooth 11 with subgingival extension greater than 5 mm. Given the complexity of the clinical situation, we opted for intentional replantation, to allow reattachment of the crown fragment by adhesive technique. After the first sixteen months of follow-up, an adequate periodontal healing, acceptable aesthetic and functional outcome were observed. The intentional replantation can be considered adequate treatment in cases of complex crown root fractures when the fracture feature is located in areas that prevent the use of other techniques for rehabilitation. In the same way it allows the maintenance of the height and volume of the alveolar bone of growing patients.

KEY WORDS: tooth replant, crown-root fractures in children, crown fragment re-attachment.

How to cite this article

DÍAZ, M. J.; BARRERA, O. V.; JANS, M. A. & ZAROR, S. C. Clinical approach of permanent maxillary incisor with complicated crown-root fracture through intentional replantation. Int. J. Odontostomat., 8(2):299-307, 2014.