Conservative Management of a Complicated Crown Fracture Using Autogenous Fragment Reattachment and Fiber Reinforcement: A Case Report

Complicated crown fractures involving pulpal exposure present both biological and restorative challenges, particularly when preservation of pulp vitality and natural tooth structure is desired.Autogenous tooth fragment reattachment is a conservative treatment option that preserves the original morphology, contour, surface texture, and optical characteristics of the fractured tooth.However, the bonded interface may remain mechanically vulnerable to functional loading; therefore, contouring and internal groove preparation are recommended to improve fracture strength recovery.This case report describes the conservative management of a complicated crown fracture in a 23-year-old male patient using partial pulpotomy with mineral trioxide aggregate (MTA), followed by autogenous tooth fragment reattachment with preheated resin composite, over-contouring, and fiber reinforcement.The patient presented approximately three hours after an accidental fall with a complicated crown fracture of the maxillary left central incisor involving enamel and dentin with pulp exposure.The tooth exhibited a positive response to cold sensibility testing, consistent with a responsive pulp, and showed no tenderness to percussion or mobility.Following partial pulpotomy and placement of MTA over the remaining pulp tissue, the fractured fragment was reattached using preheated resin composite.An over-contouring approach was subsequently performed on the buccal surface, and Interlig fiber (Angelus, Londrina, Brazil) was incorporated into a prepared groove for additional reinforcement.At the one-year follow-up, the tooth remained asymptomatic, responded positively to cold sensibility testing, and showed no tenderness to percussion, fragment loss, discoloration, periodontal ligament widening, or periapical pathology.This case illustrates a conservative approach combining vital pulp therapy, autogenous fragment reattachment, and localized fiber reinforcement while preserving natural tooth structure and esthetics.