Complex Crown-Root Fracture Management of a Maxillary Central Incisor Using Biodentine and Post: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: Complex crown-root fractures involving both the coronal and radicular structures of anterior teeth present a significant restorative and endodontic challenge, and are conventionally managed by extraction followed by prosthetic or implant-supported rehabilitation. Conservative fragment-preserving techniques, however, can offer a biologically favourable and aesthetically superior alternative when case selection is appropriate. This report describes the management of a 45-year-old female who presented with a coronally located vertical crown-root fracture of the maxillary left central incisor (tooth 21) following trauma sustained in a fall. Clinical and cone-beam computed tomography (CBCT) examination revealed a complicated crown fracture with a vertical fracture line extending palatally along the root canal to the middle third of the root. The tooth was managed conservatively with root canal treatment followed by obturation using a bioceramic sealer, reinforcement and sealing of the fracture line with Biodentine, fabrication of a post space, cementation of a post with dual-cure luting cement, core build-up, reattachment of the fractured fragment using dual-cure resin composite, and final full-coverage crown restoration. At follow-up, the tooth was retained with satisfactory functional and aesthetic outcomes. This case highlights Biodentine as a viable dentine substitute for internal reinforcement of vertically fractured roots and supports a conservative, tooth-preserving approach as a legitimate alternative to extraction in carefully selected complex crown-root fractures. Keywords: Vertical root fracture; Biodentine; crown-root fracture; fragment reattachment; bioceramic sealer; post and core; dental trauma.
Language: English
Topic: Dental Trauma and Treatments
Subfield: Emergency Medical Services
Field: Health Professions
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7213247806