PMC4235191_01
(a) Preoperative view. (b) Fractured segment. (c) Postobturation 11. (d) Post luted on 11. (e) Postoperative radiograph. (f) Postoperative view. (g) 1-year follow-up view. (h) 1-year follow-up radiograph.
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fig1
The fractured segment was held in place by the gingival attachment (Figure 1(a)). Local anesthesia was administered (1.0 cc of lidocaine 2% with 1 : 80,000 epinephrine) and the fractured segment in relation to 11 was atraumatically removed (Figure 1(b)). RCT was completed on 11 (Figure 1(c)) and post space was prepared using GG drills and Peeso reamers. The post was then luted with resin cement (Multilink, Ivoclar, Vivadent) with 2 mm of its coronal portion extending into the chamber (Figure 1(d)). Tooth fragment was reattached using resin cement (Figures 1(e) and 1(f)), and a physiological splint using ligature wire and composite resin (Ceram-X Mono+ Nanoceramic Restorative, Denstply, Konstanz, Germany) was provided for 2 weeks. The clinical and radiographic pictures after 1 year revealed favorable healing (Figures 1(g) and 1(h)).
PMC4235191_02
(a) Preoperative view. (b) Fractured segment. (c) Radiograph of prepared post space. (d) Flap elevated to expose margins of fracture. (e) Postoperative view. (f) 1-year follow-up radiograph.
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fig2
A similar case of a 28-year-old male presented with Ellis class III fracture of the right maxillary lateral incisor incurred in an RTA, with subgingival extension beyond junctional epithelium (Figures 2(a) and 2(b)). Hemostasis was achieved (Figure 2(d)). The flap was repositioned and sutured (Figure 2(e)), followed by physiological splinting for 2 weeks. At the 1-year followup, the tooth was clinically and radiographically healthy and the crown was esthetically satisfactory (Figure 2(f)).
PMC4235191_03
(a) Preoperative view. (b) Fractured segment. (c) Fragment reattached. (d) 1-year follow-up view.
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fig3
Hard tissue examination revealed an Ellis class III fracture of 21 and a class I fracture of 11 (Figure 3(a)). RCT, fiber post (Glassix-NORDIN, Switzerland, diameter 1.1 mm) cementation, and reattachment of the fractured segment were planned and performed on 21 (Figures 3(b) and 3(c)). 11 was restored with composite resin. The 1-year follow-up clinical evaluation revealed acceptable aesthetics and function (Figure 3(d)).