Combined Periodontal, Endodontic and Restorative Management of a Pediatric Maxillary Crown-Root Fracture

Abstract

Aims: This case study illustrates the successful preservation and functional restoration of a traumatised maxillary central incisor via a multidisciplinary, conservative approach, providing further evidence in favour of integrated treatment strategies for young patients. Presentation of Case: An 11-year-old female patient presented with a history of dental trauma affecting her upper right central incisor (tooth #11). An intraoral examination revealed a complex crown-root fracture involving the vestibular, palatal, mesial, distal and incisal surfaces, with a subgingival extension that compromised the biological width. The diagnosis was a complicated crown-root fracture with pulpal involvement. Treatment consisted of endodontic therapy and surgical crown lengthening to re-establish the supracrestal tissue attachment. A definitive restoration was achieved using a glassfiber post and a stratified composite build-up with a silicone guide. Despite the inability to conduct long-term follow-up due to socioeconomic limitations, the immediate outcome was aesthetically and functionally successful. Discussion: This case study illustrates how a well-planned, interdisciplinary approach can effectively restore severely traumatised anterior teeth in paediatric patients, thereby avoiding extraction and maintaining aesthetics and function. Although, the lack of follow-up due to poor financial status and unavailability of the patient’s family presented itself as the main shotcoming of this case. Conclusion: It emphasises the importance of individualised, conservative strategies and highlights the challenges in ensuring follow-up care for vulnerable populations.