Crown-root reattachment of severe subgingival tooth fracture: a 15-month periodontal evaluation

Traumatic tooth fractures represent an intriguing challenge for clinicians, in particular, when they involve the anterior region of the upper dental arch. In these situations, esthetic, psychosocial, functional, and therapeutic problems may have a negative effect on the individual's quality of life. In addition, fractures which involve the biologic width of the periodontium are even more difficult to treat. An interdisciplinary approach based on crown lengthening with or without orthodontic extrusion and the final prosthetic rehabilitation represent the standard modality of treatment for these conditions in order to restore the appropriate biologic dimension and to esthetically finalize the damage. However, if the margins of the fragment and the tooth show a perfect juxtaposition with no interfragmentary space, an adhesive technique may be indicated. The aim of this case-report study is to describe the treatment of a severe subgingival tooth facture by means of adhesive reattachment technique of the fragment followed by a periodontal evaluation over a 15-month period.