Management of fractured tooth by fragment reattachment

Traumatic injuries to anterior teeth are common among young individuals and often present with significant esthetic and functional implications. When the fractured tooth fragment is intact and promptly recovered, fragment reattachment provides a conservative and highly esthetic treatment option. This case report describes the management of an uncomplicated crown fracture of the maxillary left central incisor in a 20-year-old male following a fall. Clinical examination revealed a horizontal enamel–dentin fracture at the middle–incisal third junction, with radiographs confirming the absence of root involvement. The patient presented within one hour of the accident, and the fractured fragment, stored in water, remained well-hydrated. After local anesthesia and rubber dam isolation, the fractured tooth and fragment were disinfected, and circumferential beveling was performed to enhance bonding surface area. Mineral trioxide aggregate was placed as an indirect pulp capping material, followed by etching, bonding, and reattachment using a nanocomposite flowable resin to ensure optimal adaptation within the limited interfacial space. Final finishing and polishing were completed using a multi-step system. Follow-up evaluations at 1 week, 1 month, 3 months, and 6 months demonstrated stable clinical and radiographic outcomes, with the tooth exhibiting normal pulp sensibility, satisfactory color match with adjacent teeth, and no signs of fracture line discoloration, detachment, or functional compromise. This case highlights that, when the fractured segment is available and properly preserved, fragment reattachment offers a predictable, biologically favorable, and esthetically superior restorative option, supported by advancements in adhesive dentistry and conservative clinical protocols.