Sir, I was interested to read Damian Panchal's case report on crown fracture.1 I carried out a very similar re-attachment of the incisal half of an upper central incisor for a 19-year-old male on a Sunday morning in October 2006 following trauma on the previous evening.

I used no preparation and merely attached the fragment with acid etch, bond and low viscosity composite (Fig. 1). Rubber dam was not used and other treatment options were not considered. A very limited prognosis was suggested.

Fig. 1
figure 1

The tooth fragment was attached with acid etch, bond and low viscosity composite

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Although we were all very satisfied with the immediate result, I went away thinking that it was not likely to last long-term. Having given it some further thought, I then took an impression for a non-precious metal backing which was cemented in place with Panavia Ex two weeks later. In 2013 he came back to see me. The tooth was still looking good. There was no discolouration, no apical pathology and a vital pulp test (Fig. 2). I recently contacted him (now almost 13 years since the reattachment) to gain consent for this letter and he tells me that all is still good.

Fig. 2
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The tooth seven years later

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These days, if the incisal edge were more translucent, an alternative backing material could be considered. If space is needed for the backing, I would suggest temporarily adding a little pimple of composite labially to the lower incisors that oppose the upper incisors adjacent to the traumatised tooth. The backing can then be cemented and impressions taken for an upper vacuum formed retainer to be used only at night to maintain the position of the upper teeth. The occlusion will then settle 'Dahl style' and the composite can be removed from the lower incisors. If appropriate, the continued use of the retainer could be considered on an occasional basis. I did not provide a retainer.