Management of Fractured Fragment With Reattachment: A Case Report With 2-Year Follow-Up

Fragment reattachment is the most conservative treatment approach for uncomplicated crown fractures, which enables the restoration of the original tooth structure and the preservation of the remaining tooth structure. A 15-year-old patient reported with an uncomplicated crown fracture of the maxillary left central incisor involving enamel and dentin. Pulp sensibility testing had a normal response and radiographic examination revealed no periapical pathology. The retrieved fractured fragment had good marginal adaptation. Following rehydration, fragment reattachment was performed under rubber dam isolation using an etch-and-rinse protocol, a two-coat adhesive application and nanohybrid flowable composite. At the second appointment, a V-shaped retentive groove of 0.7-mm depth was placed in both the labial and palatal aspects, extending 2 mm on either side of the fracture line, followed by composite restoration. The patient was reviewed at 6 weeks, 1 year and 2 years in accordance with the International Association of Dental Traumatology (IADT) guidelines. Throughout the follow-up period, the reattached fragment remained clinically intact with no evidence of debonding, marginal discolouration or fracture recurrence. Pulp sensibility testing remained normal, and radiographic examination revealed no periapical changes at all follow-up intervals, demonstrating sustained aesthetic and functional stability over a 2-year follow-up period.