Navigating Crown-Root Fracture Complexities in an Adolescent

Complicated crown-root fracture is a severe dental injury that affects the enamel, dentine, cementum, and pulp, representing a small percentage of dental trauma cases in permanent teeth. This case report discusses the management of a complicated crown-root fracture to the maxillary left central incisor in a 14-year-old male patient following a motor vehicle accident. The fracture extended subgingivally, complicating access and restoration. Initial treatment attempts by a general dentist were unsuccessful due to the repeated dislodgement of restorations. A multidisciplinary approach was taken and options such as orthodontic extrusion, gingivectomy, and surgical extrusion were considered. Root canal treatment followed by gingivectomy was performed to expose the fracture line for restoration. While the fracture line for restoration was successfully exposed, the intrinsic discoloration was overlooked. The key to treatment success was the consideration of supracrestal tissue attachment, a crucial factor in maintaining periodontal health. Regular follow-up is essential to monitor the tooth's endodontic-periodontic status and ensure lasting success.