Diagnosis and Treatment of an Incomplete Crown-Root Fracture with Intentional Replantation: A Case Report

Abstract

Acute traumatic injuries to the maxillary incisors may lead to a crown-root fracture. If the fracture is left untreated, the fracture line will propagate and extend apically, resulting in microbial contamination of the attachment apparatus and subsequent bone loss. In cases with extensive periodontal involvement, extraction has been suggested. However, bonding and sealing the fracture line with a biocompatible material seems to be an effective alternative treatment option. In this case report, management of a central incisor with an incomplete crown-root fracture that showed signs and symptoms of vertical root fracture is discussed. As the extension of the fracture line was not clear, intentional replantation and sealing the fracture line with a glass ionomer was performed. The tooth showed no signs and symptoms at six-month follow up, and the radiographic examination exhibited substantial bone repair.

Tooth intentional replantation from 1964 to 2023: A bibliometric analysis

“…The analysis of research themes showed that IR for periapical diseases gained the most significant attention in publications before 2000, whereas IR for vertical root fractures, 35–39 crown root fractures, 40–43 and periodontic diseases 44–48 gradually became the main theme since 2001. During 2001–2005 and 2010–2015, several materials were used for the management of vertical root fractures with IR, including self‐etching dual‐cure adhesive resin cement, 35,36 calcium‐enriched adhesive resin cement, 49 and 4‐methacryloxyethyl trimellitate anhyride/methacrylate‐tri‐n‐butyl borane (4‐META/MMA‐TBB) resin cement 37–39 .…”

“…The development of these materials appears to offer a therapeutic possibility for the treatment of vertical root fractures using the IR technique. Since 2008, an increasing number of studies have evaluated the use of IR for teeth with crown root fractures, 40–43 in some cases with 180‐degree rotation 40,43 . Furthermore, researchers have noted that the use of biomaterials (e.g., leukocyte‐platelet‐rich fibrin) with IR seems to be beneficial for rescuing periodontally hopeless teeth, which might become a future research direction 45,47,50–53 …”

“…The co-occurrence of these 29 keywords was analyzed, and a network structure was constructed. The density visualization map showed that the most frequent keywords were "endodontic disease," "case report," "root canal treatment," and "intentional replantation" (Fig- The analysis of research themes showed that IR for periapical diseases gained the most significant attention in publications before 2000, whereas IR for vertical root fractures, [35][36][37][38][39] crown root fractures, [40][41][42][43] and periodontic diseases [44][45][46][47][48] Note: q1: first quartile of the publication year. q3: third quartile of the publication year.…”

“…*p-value < 0.05 evaluated the use of IR for teeth with crown root fractures, [40][41][42][43] in some cases with 180-degree rotation. 40,43 Furthermore, researchers have noted that the use of biomaterials (e.g., leukocyteplatelet-rich fibrin) with IR seems to be beneficial for rescuing periodontally hopeless teeth, which might become a future research direction.…”