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Available online at ajdhs.com 

Asian Journal of Dental and Health Sciences 
Open Access to Dental and Medical Research 

Copyright  © 2025 The  Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 
which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the 

original author and source are credited  

 

 

Endodontic Management of Crown Fracture Using Reattachment Technique 
with Fibre Post: Case Report 

Dr. Siddhartha Das 1*, Dr. Neha Pal 2 

1 Associate Professor, Department of Conservative Dentistry and Endodontics, Burdwan Dental College and Hospital, Burdwan, West Bengal, India. 

2 Periodontist and Implantologist, Private clinician, Kolkata, West Bengal, India 

Article Info: 
_____________________________________________ 
Article History: 

Received   23 May 2025     
Reviewed  06 July 2025 
Accepted   30 July 2025 
Published 15 Sep 2025 

_____________________________________________ 
Cite this article as:  

Das S, Pal N, Endodontic Management of 
Crown Fracture Using Reattachment 
Technique with Fibre Post: Case Report, 
Asian Journal of Dental and Health Sciences. 
2025; 5(3):16-18                                                                   

DOI: http://dx.doi.org/10.22270/ajdhs.v5i3.135              

Abstract 
_________________________________________________________________________________________________________________ 

Anterior crown fracture from trauma is quite embarrassing for the patient because it impacts the 
facial esthetics of the person. These traumatic dental injuries are found to be maximum in the 
maxillary incisors. Treatment of these fractures poses a challenge to the clinician as the main 
objective of the treatment is to restore esthetics and phonetics of the patient along with pain 
management. Several treatment methods are available but restoring the patient’s own fractured 
fragment of tooth if available is the most viable restorative technique as it provides fast and 
esthetically pleasing results. Hence, this article reports the successful management of crown fracture 
which was treated with reattachment technique using fibre post. 

Keywords: crown fracture, trauma, reattachment, fibre post     

*Address for Correspondence:   

Dr. Siddhartha Das, Associate Professor, Department of Conservative Dentistry and Endodontics, Burdwan Dental College and Hospital, Burdwan, 
West Bengal, India. 

 

Introduction: 

Coronal fractures of teeth are the most common 
consequence of dental trauma. Injury strikes maximum 
in the maxillary central incisors, followed by maxillary 
lateral incisors, mandibular incisors and maxillary 
canines being less frequent. This sequence is due to 
their location in the mouth. Traumatic injuries have 
physical, psychological and social impact on the quality 
of life of the patients.1 Restoring coronal fractures poses 
challenge to the clinician as it requires proper diagnosis 
and treatment plan. Several factors need to be kept in 
mind like the position of fracture line, biologic width, 
presence or absence of pulpal involvement, presence or 
absence of the broken fragment with its viability for 
usage, occlusion and the esthetics of the concerned 
patient before implementing proper treatment 
planning.2 Fracture restored with composite resin, 
fragment reattachment, endodontic treatment with post 
core supported prosthesis are different modes of 
treatment to replace the broken tooth. If the broken 
fragment is found to be in good condition, reattachment 
is the most viable option of fracture tooth management 
as it restores the original morphology alongwith 
function of tooth and esthetics. Furthermore it is also 
economical treatment which provides an emotional and 

psychological response to the patient.3 The following 
case report presents management of coronal fracture of 
maxillary central incisor by reattachment.  

Case Presentation: 

A 28-year-old male reported to Department of 
Conservative Dentistry and Endodontics with chief 
complaint of pain in fractured upper anterior tooth due 
to road traffic accident an hour before. Clinically Ellis 
class III fracture in right maxillary central incisor (11) 
was detected (Figure 1). On intraoral examination, soft 
tissue injury and mobility of the injured tooth was not 
evident. Patient medical history was nothing significant. 
Fractured fragment was just loosely attached to leftover 
tooth structure. Removal of broken fragment was done 
under local anaesthesia (2% Lignocaine) and stored in 
normal saline to maintain hydration and natural 
appearance (Figure 2). Patient was interested in 
maintaining the tooth by reattaching the fragment. As 
the fragment was found to be in good condition, patient 
was explained about the procedural approach of 
reattachment. Pulp chamber was exposed after removal 
of the fragment, hence working length was found with 
apex locator (Root ZX, J Morita Corp., Japan). Cleaning 
and shaping of canal was completed using hand files 
upto master apical size of 60 K file with intermittent 

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Das et al.                                                                                                                                       Asian Journal of Dental and Health Sciences. 2025; 5(3):16-18 

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irrigation by 3%sodium hypochlorite. Canal was dried 
with paper points and obturation was completed with 
sectional method maintaining 5mm of apical seal. Post 
space preparation was done with Peeso reamers for the 
placement of glass fibre post in canal and proper length 
of post was confirmed with a radiograph. Coronal end of 
post was cut with diamond abrasive points such that 
4mm of post is available above the coronal surface of 
remaining tooth structure to enhance the retention of 
the fragment. A vertical groove of certain depth was 
prepared on the dentin surface of fractured fragment 
using round carbide bur which helped in fitting the 
fragment to the post extension. The fractured fragment, 
fibre post and remaining tooth structure along with the 
root canal was etched with 37%orthophosphoric acid 

for 15 seconds, rinsed, blot dried and bonding agent was 
applied. Light curing was done for 30 seconds for the 
remaining tooth and fibre post. Fibre post was luted 
with resin cement (Calibra, Dentsply Sirona) and placed 
in the canal and flowable composite (Tetric N Flow, 
Ivoclar Vivadent) was used to fill up the dentinal groove 
and remaining canal space. Fragment was properly 
approximated to the actual leftover tooth structure and 
light curing was done. Composite finishing bur was used 
to get rid of the excess material and occlusion was 
checked with the antagonist tooth (Figure 3).  Patient 
recalled after 1 month for follow up and radiograph was 
taken which showed proper fit and adaptation of the 
fragment (Figure 4).

 

   

          Figure 1: Fracture of crown (11)                              Figure 2: Removal of fractured fragment 

   

Figure 3: Fragment approximation reattachment        Figure 4: 1 month follow up radiograph 

 

Discussion: 

Traumatic injuries of permanent incisors with pulpal 
involvement constitutes 11%-15% out of which 96% 
involves maxillary central incisors.4 Traditional 
methods of treatment of fractured tooth were cast metal 
post and core supported by prosthesis, use of composite 
resins for fracture treatment. But disadvantage of 
composite resins was that this material does not 
resemble enamel or dentin structurally as that of 
original tooth though they possess optical properties.5 
However, use of cast metal post with metal ceramic or 
all ceramic crowns causes wearing of enamel of the 
opposing dentition which can lead to sensitivity to the 
patient and chances of post fracture is also high in cast 
metal post core. With the advancement of adhesive 
dentistry, reattachment of fractured fragment provides 
a better choice for treatment provided that biologic 
factors, materials and techniques are well assessed and 
managed. Reattachment procedure reduces the chances 
of wear of natural tooth and maintains benefit of 

preserving original colour match, contacts, contour and 
incisal translucency.6,7 Reattachment is a conservative 
and cost-effective approach for anterior tooth fracture 
which also gives psychologically positive response to 
the patient as the natural tooth structure is preserved. 
For reattachment procedure, storage of the broken 
piece has been reported an important factor to maintain 
the vitality and original esthetic appearance of the tooth. 
Different storage medium includes normal saline, 
distilled water, saliva, milk and Hanks balanced 
solution. In this case, the fractured fragment was 
removed and kept in sterile isotonic saline solution to 
maintain hydration.8 Martos et al revealed no significant 
effect was found on survival, colour and bonding 
strength of the restored tooth based on the storage 
medium used for broken fragment.9 Fractured fragment 
was found to be in good condition with accuracy in 
fitting to the remaining tooth structure with the fracture 
line. Hence, reattachment using fibre post was chosen as 
the treatment plan for this case. Fibre posts was 



Das et al.                                                                                                                                       Asian Journal of Dental and Health Sciences. 2025; 5(3):16-18 

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considered over cast metal posts as fibre posts are 
esthetic, exhibits good bonding to between post and 
cement, less chairside time and elastic modulus similar 
to that of dentin which allows uniform distribution of 
occlusal stresses in the radicular dentin thus minimizes 
possibility of tooth fracture.10,11 Using fibre posts in 
addition with composite and adhesive materials creates 
a monoblock which further helps in reinforcement of 
the tooth structure.12  Reis et al reported that fracture 
resistance of tooth when done by simple reattachment 
was 37.1% but placement of vertical internal groove in 
fracture fragment or superficial overcontouring 
enhances the fracture resistance to 90.5%.13 In this case 
vertical internal grooves were placed in fractured 
fragment to increase fracture resistance. Dual cure resin 
cement with self-adhesive property was used for 
cementation of the fibre post in root canal as this 
cement possess high bond strength and reduces 
microleakage. Fragment reattachment was completed to 
the remaining crown structure using flowable 
composite resin over the fracture line that provides 
proper colour stability, minimizes inclusion of voids and 
aids to attain bond strength of the fragment to the tooth 
structure.14  

Conclusion: 

Treatment and material advances related to adhesive 
dentistry has proved reattachment as minimally 
invasive treatment for revitalizing esthetics and 
function with a successful outcome. For traumatized 
patient with fractured teeth, reattachment procedure 
serves the primary choice of treatment as it maintains 
natural esthetics without sacrificing natural tooth 
structure. 

Acknowledgement: The authors declare that there are 
no acknowledgements 

Conflict of Interest: The authors declare no conflicts of 
interest 

Author contributions: Both authors have equal 
contributions in the preparation of the manuscript. 

Source of funding: Nil 

Informed consent: Consent was obtained from the 
patient. 

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of Traumatic Injuries to the Teeth. Oxford: Blackwell Munksgaard; 
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2. Macedo GV, Diaz PI, De O et al. Reattachment of anterior teeth with 
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9. Martos J, Majzoob YM, Siqnori C et al. Adhesive crown fragment 
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https://doi.org/10.1111/j.1708-8240.2008.00142.x
https://doi.org/10.1111/j.1708-8240.2008.00142.x
https://doi.org/10.4103/0976-237X.95109
https://doi.org/10.1111/j.1600-9657.2011.01015.x
https://doi.org/10.4103/2321-4619.129080
https://doi.org/10.4103/2278-9626.103393
https://doi.org/10.4012/dmj.25.145
https://doi.org/10.1016/j.joen.2006.10.009

