PMC5504940_01
Clinical aspects of the crown fracture of the maxillary right central incisor.
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A 9-year-old female patient presented at the postgraduate clinic of dentistry at the State University of Rio de Janeiro, Rio de Janeiro, Brazil, with a coronal fracture and pulp exposure of the right maxillary central incisor (Figures 1 and 2) that had occurred immediately after an accident.
Clinical aspects of the pulp exposure (a). Original tooth fragment recovered at the accident site and stored in milk (b).
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A 9-year-old female patient presented at the postgraduate clinic of dentistry at the State University of Rio de Janeiro, Rio de Janeiro, Brazil, with a coronal fracture and pulp exposure of the right maxillary central incisor (Figures 1 and 2) that had occurred immediately after an accident. The tooth fragment presented good positional stability (Figure 2).
Clinical aspect of the original reattached tooth fragment.
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A good esthetic result was obtained, and beveling the adhesive interfaces was not necessary (Figure 3).
PMC5504940_02
Tooth fragment detached after 5 years and development of the dentin barrier.
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The hard tissue barrier was complete and had remained intact after 5 years of protection (Figure 4).
Discoloration of the fractured tooth crown after 10 years.
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During a follow-up 5 years later, the same right maxillary central incisor presented clinical discoloration (Figure 5) and absence of sensitivity during pulp vitality tests.
Radiograph showing periapical radiolucency.
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A radiographic image revealed periapical radiolucency (Figure 6).
Radiograph after endodontic treatment.
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The new treatment plan included endodontic treatment (Figure 7), followed by nonvital tooth bleaching and light-cured composite resin restoration.
Clinical aspects after internal nonvital bleaching.
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The final tooth color after bleaching is shown in Figure 8.
Clinical aspects after composite resin restoration.
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The same restorative materials that were applied to restore palatal access were used (Figure 9).
Final clinical appearance.
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An esthetic and natural-looking restoration was achieved (Figure 10).