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The management of a complicated crown-root fracture incorporating modified crown-lengthening surgery


Anterior teeth with subgingival fractures require a multidisciplinary management approach with regards to biological, functional and aesthetic factors. This case report emphasises the use of a minimally invasive technique combined with a sequence of therapies to treat a complicated crown-root fracture and reviews the critical factors to ensure predictable outcomes. Endodontic treatment was undertaken due to exposure of the pulp in a complicated crown-root fracture of the maxillary right central incisor. Extrusion of the fractured fragment was performed to expose the fracture margin under the alveolar bone. Modified crown-lengthening surgery was used to reconstruct the biologic width. The traumatised tooth was restored with a glass fibre post and resin core, which fit the biological requirements. Finally, an all-ceramic crown fulfilled biomimetic aesthetics. This multidisciplinary approach achieved a good long-term prognosis with regards to periodontal and periapical healing.

Key points

  • Emphasises the use of a minimally invasive technique combined with a sequence of therapies to treat a complicated crown-root fracture.

  • Reviews the critical factors to ensure predictable outcomes.

  • Recovers the biologic width with regards to biological, functional and aesthetic aspects.

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Correspondence to Haojie Yu or Haihua Zhu.

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Yu, H., Zhu, H. The management of a complicated crown-root fracture incorporating modified crown-lengthening surgery. Br Dent J 230, 217–222 (2021).

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