The management of a complicated crown-root fracture incorporating modified crown-lengthening surgery

• Published in: British dental journal Vol. 230; no. 4; pp. 217 - 222
• Main Authors: Yu, Haojie, Zhu, Haihua
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.02.2021; Nature Publishing Group
• Subjects: Aesthetics; Alveolar bone; Bone surgery; Clinical; Crowns; Dental pulp; Dentistry; Esthetics, Dental; Fractures; Humans; Maxilla; Post and Core Technique; Tooth Crown - surgery; Tooth Fractures - surgery; Tooth Root
• ISSN: 0007-0610; 1476-5373; 1476-5373
• DOI: 10.1038/s41415-021-2653-4

Anterior teeth with subgingival fractures require a multidisciplinary management approach with regards to biological, functional and aesthetic factors. This case report emphasises the use of a minimally invasive technique combined with a sequence of therapies to treat a complicated crown-root fracture and reviews the critical factors to ensure predictable outcomes. Endodontic treatment was undertaken due to exposure of the pulp in a complicated crown-root fracture of the maxillary right central incisor. Extrusion of the fractured fragment was performed to expose the fracture margin under the alveolar bone. Modified crown-lengthening surgery was used to reconstruct the biologic width. The traumatised tooth was restored with a glass fibre post and resin core, which fit the biological requirements. Finally, an all-ceramic crown fulfilled biomimetic aesthetics. This multidisciplinary approach achieved a good long-term prognosis with regards to periodontal and periapical healing. Key points Emphasises the use of a minimally invasive technique combined with a sequence of therapies to treat a complicated crown-root fracture. Reviews the critical factors to ensure predictable outcomes. Recovers the biologic width with regards to biological, functional and aesthetic aspects.