Innovative Conservative Management of a Mid-root Fracture in a Maxillary Lateral Incisor: A Case Report

A 22-year-old male patient presented with trauma-induced injury to the maxillary anterior teeth following a road traffic accident. Clinical and radiographic examination revealed a middle-third horizontal root fracture with pulpal necrosis in the maxillary lateral incisor and a complicated crown fracture with symptomatic irreversible pulpitis in the maxillary central incisor. As the patient declined surgical intervention, a conservative multidisciplinary treatment approach was planned. The fractured root was repositioned and stabilized using a semi-rigid splint followed by non-surgical endodontic treatment. After sectional obturation, the fracture interface was managed using orthograde placement of bioactive glass slurry with intermittent ultrasonic activation to enhance penetration and adaptation within the interfragmentary space. A fiber post luted with dual-cure composite resin was subsequently used to reinforce and stabilize the fractured segments. The adjacent central incisor was treated endodontically and restored using an all-ceramic Richmond crown because of extensive coronal tooth structure loss. Clinical and radiographic follow-up demonstrated satisfactory stabilization, preservation of periodontal integrity, favorable healing, and acceptable esthetic rehabilitation. The present case highlights the potential of bioactive glass-assisted conservative management as a minimally invasive strategy for the treatment of middle-third horizontal root fractures while simultaneously restoring function and esthetics in severely compromised anterior teeth.