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

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.