Background
A 13-year-old girl, was brought to our clinic after accidentally hitting her face against a wall. She had fractured her upper front tooth (left central incisor – 21) four days earlier. Her parents had carefully preserved the broken piece and brought it with them.
Clinical Findings
- Chief Complaint: Broken upper front tooth
- History: Trauma due to collision with a wall, 4 days back
- Tooth Involved: 21 (Ellis Class III fracture with pulp exposure)
- Additional Findings:
- Grossly decayed 16, 36, 35
- Posterior crossbite
- OPG revealed a large periapical lesion in 36 and 35
Treatment Plan
Since the fractured fragment was available, a biological restoration (fragment reattachment) was planned along with Cvek’s pulpotomy for vital pulp therapy.
Step-by-Step Treatment
1. Pre-Operative Assessment
- OPG taken for full-mouth evaluation
- Pulp vitality confirmed
Parent consent obtained for reattachment procedure
2. Pulp Therapy
- Access cavity opened
- Cvek’s pulpotomy with MTA performed on 21
- Checking the repositioning of the broken fragment
3. Tooth Preparation
- Beveling of the fractured edges of the tooth and the fragment
- Acid etching (37% phosphoric acid) done on both the fragment and the tooth surface
4. Bonding and Reattachment
- Bonding agent applied and cured
- Composite resin used for reattachment of the fragment
- Proper adaptation and alignment ensured
5. Finishing and Polishing
- The tooth was polished and finished to restore natural aesthetics and function
Post-Operative Results
- The tooth regained its natural look as the child’s own fragment was reused
- Immediate esthetic and psychological satisfaction for the patient
- Vital pulp preserved, supporting long-term tooth survival
Visual Documentation
- Pre-Operative Photos: Broken 21, pulp exposure visible
- Intra-Operative Photos: Pulpotomy, beveling, etching, bonding, reattachment
- Post-Operative Photo: Final polished restoration
- Radiograph (OPG): Pre-op findings documented
Watch the treatment video here: https://www.instagram.com/reel/DN2KbKE5EQl/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==
Takeaway for Parents
When children suffer dental trauma, quick action can make all the difference. In this case, because the parents saved the broken tooth fragment, we were able to restore the natural tooth with minimal intervention.
Key message:
- If your child breaks a tooth, always store the fragment in milk or saline and bring it to the dentist immediately.
- Modern pediatric dentistry offers conservative, child-friendly treatments that preserve natural teeth and protect your child’s smile.
✅ This case highlights the importance of early dental care after trauma and how advanced pediatric dentistry can save broken teeth with long-lasting results.