Conservative Management of a Complicated Crown- Root Fracture with Partial Pulpotomy and Fragment Reattachment: Long Term Follow-Up Case Report

Odabaş E and Sönmez I*
 

Private Practice, İstanbul, Türkey
Department of Pediatric Dentistry, Aydin Adnan Menderes University, Aydin, Turkey

^*Correspondance to: Işıl Sönmez 

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Abstract:

Complicated crown fractures in immature permanent teeth present significant functional and esthetic challenges, particularly when accompanied by pulpal exposure and a mobile coronal fragment. This case describes the management of a 10-year-old systemically healthy male patient who presented with a complicated crown-root fracture of the left maxillary central incisor following trauma. The patient attended our clinic three days after injury. Clinical and radiographic examination revealed a crown-root fracture with subgingival extension; the mesial coronal fragment was mobile and subsequently removed, after which pulpal exposure was identified. A partial pulpotomy (Cvek pulpotomy) was performed to preserve pulp vitality. The original fragment was reattached using an adhesive protocol, and the coronal defect was restored with composite resin to achieve functional and esthetic rehabilitation. The tooth was followed clinically and radiographically for 32 months, remaining asymptomatic with a positive vitality response and no radiographic evidence of periapical pathology. Both the reattached fragment and composite restoration maintained stable structural and esthetic integrity throughout the follow-up period. This case suggests that the combination of partial pulpotomy and fragment reattachment may represent a minimally invasive and reliable treatment option for complicated crown-root fractures in young permanent teeth, supporting long-term pulp vitality and favorable esthetic and functional outcomes.  

Keywords:

Complicated crown-root fracture; Fragment reattachment; Partial pulpotomy

Cite the Article:

Odabaş E, Sönmez I. Conservative Management of a Complicated Crown- Root Fracture with Partial Pulpotomy and Fragment Reattachment: Long Term Follow-Up Case Report. Clin Case Rep Int. 2026; 10: 1778..