Crown-Root Reattachment of a Severe Subgingival Tooth Fracture: A 15-Month Periodontal Evaluation

Traumatic tooth fractures represent an intriguing challenge for clinicians, particularly when they involve the anterior region of the maxilla. In such situations, esthetic, psychosocial, functional, and therapeutic problems may have a negative effect on the patient's quality of life. In addition, fractures that 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 definitive prosthetic rehabilitation represent the standard modality of treatment for these conditions to restore the appropriate biologic dimension and to reduce the damage esthetically. However, if the margins of the fragment and the tooth show perfect juxtaposition with no interfragmentary space, an adhesive technique may be indicated. The aim of this case report is to describe the treatment of a severe subgingival tooth fracture by means of adhesive reattachment of the fragment followed by a periodontal evaluation over a 15-month period.