AUTHOR(S): Dr. Deshpande Prashanth, Dr. Rutika R Naik, Dr. K Shashikala, Dr. Kirankumar Metta, Dr. Prashanth BR

ABSTRACT:Background: Maxillary central incisor is most commonly affected tooth during trauma followed by maxillary lateral incisor and mandibular incisors. Trauma to the anterior tooth requires urgent care because of essentiality of preserving natural tooth. When complicated crown fracture occurs it necessitates endodontic treatment and restoration of fractured crown segment with post in the canal. Case-report: A male patient of age 18 years reported to the S.B. Patil Dental Hospital, Bidar for dental trauma to the maxillary left central incisor with pulp exposed but palatal tooth structure holding the fractured crown segment. Patient had fight with his colleague one day before and suffered a blow onto his front tooth. Fractured crown segment removed and stored in normal saline. Two visit root canal treatment planned and performed. After two days, post space prepared, indirect impression with putty light body taken for indirect post. Then appropriate glass fiber post selected and para core composite added onto the post to get custom-fit conical post. Putty with light body impression taken to get cast with post space in which conical post checked for snugly fit. Now Modified conical post bonded to fractured crown segment using resin cement and the whole unit resembling Richmond crown, referred to as Hybrid Richmond crown bonded into the root canal using resin cement. Minute visible cracked line labially and palatally restored with direct composite veneering. After 12 months follow-up shows healthy tooth structure and surrounding tissue. Conclusion: Here a special technique of crown fracture reattachment documented (Hybrid Richmond crown) – in which custom made conical glass fiber post attached to fractured crown segment and bonded into the root canal using resin cement which gives Monoblock effect. The case represents better transfer and distribution of forces along the long axis of tooth and also long term survival of the tooth.

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