Manejo clínico de fratura coronária complicada com reintegração de fragmento dentário autógeno e tratamento endodôntico: relato de caso

Abstract

Complicated crown fractures represent a clinical challenge due to pulpal involvement and the need for functional and esthetic rehabilitation of the affected tooth. This study aimed to report and discuss the management of a complicated crown fracture in a permanent tooth through the association of autogenous tooth fragment reattachment and endodontic treatment. This case report describes a 14-year-old female patient who experienced dental trauma during sports practice, resulting in a complicated crown fracture of the left maxillary central incisor. Following clinical and radiographic examination, a treatment plan based on tooth fragment reattachment, followed by endodontic therapy and definitive restoration, was established. The clinical protocol included fragment rehydration and reattachment using a conventional adhesive protocol, chemomechanical preparation of the root canal system, placement of calcium hydroxide as an intracanal medicament, root canal obturation using the lateral condensation technique, and palatal reconstruction with composite resin. After a five-month clinical and radiographic follow-up period, fragment integrity was maintained, with no symptoms, periodontal alterations, or periapical findings suggestive of treatment failure. The findings of this case report demonstrate that the association of autogenous tooth fragment reattachment and endodontic treatment is a conservative and effective approach for the management of complicated crown fractures, providing satisfactory esthetic and functional outcomes.