Saving a Fractured Smile: Vital Pulp Preservation in a 9-Year-Old Patient

A 9-year-old boy suffered dental trauma during school play, hitting a wall with his face. Both maxillary central incisors were fractured. Tooth 11 had lost the entire incisal edge, while tooth 21 presented a more severe injury — a vertical fracture extending deeply subgingivally, clearly visible on RVG and high-resolution (150 µm) CBCT. The mobile coronal fragment of tooth 21 was still attached to the gingiva but completely detached from the crown. Standard procedure in such cases typically involves: • Removal of the fractured segment, • Which most likely leads to pulp necrosis, • Followed by endodontic treatment and complex restorative work. Moreover, due to the depth of the fracture, proper coronal reconstruction would be extremely difficult, if not impossible.…