This young man presented to my office in no acute distress. He had a tooth that was sore, but the injury had occurred when he was out of state two weeks earlier. The delay is unfortunate as treatment at that time may have been restricted to the coronal aspect of the tooth. While there was no pain initially, with the passage of time the tooth became symptomatic. As such and knowing that there had been continual exposure to bacteria, nonsurgical endodontic therapy was the best option.
Complicating matters was that this young man had an important social event a few days later. Coordinating his parents schedule and the restorative treatment appointments he would require was going to be a challenge in that short period of time. Although it is not easily detected from the preoperative photos, tooth #9 was fractured and luxated buccally. Interestingly enough, the young man had the presence of mind to hang onto the fractured segment of the tooth. It was dry, but he still had it in his possession.
After anesthesia, I was able to match up the fracture lines of the broken segment and the attached tooth. Nonsurgical treatment was completed and using composite resin, the broken segment was bonded into place as a core buildup was being placed.
This young man was able to attend his social event and according to his mother, smiled the whole time. While the opacity of the bonded fragment is evident to my eye, the young man and his mother were quite pleased. The bonded segment hung on for seven or eight months prior to debonding.
Considering the length of time the tooth fragment was dry, I’m surprised it lasted that long. I thought it was interesting that the young man had the presence of mind to keep the fragment all that time.
