Management of Traumatized Permanent Maxillary Immature Incisor with Oblique Subgingival Crownroot Fracture

Abstract

Background: Trauma to the anterior teeth is a common injury in young children. Themaxillary incisors being the most affected. Although root fractures are rare, theydo occur and were previously and often considered hopeless and were extracted.The time between the injury and the initiation of treatment, level of the fractureline, and stage of root development are some criteria to be considered whenchoosing a treatment approach for a complicated tooth fracture. This case reportdescribes the management of a traumatized immature maxillary central incisorwith Elise class IV fracture with vertical oblique subgingival fracture of the root.Materials and method: Apexification was carried out using biodentine followed byremoval of the fractured segment. A fiber post was cemented in the root canalwith resin cement. The coronal portion of the tooth was restored using anteriorlight cured composite material. The tooth was examined and evaluated after 1week and after 2 months by clinical examination and radiographical evaluation ofroot development.Results: The follow up evaluation revealed clinical and radiographical success.Radiographic view showed continued development in the apex of the root andshowed normal periodontal ligament space and dense lamina dura.Conclusion: Extraction should not be the first choice of treatment for extensivelydamaged young permanent teeth in the anterior region; instead, alternativetreatment modalities must be considered. The traumatized immature tooth wassaved and restored.