The study was conducted by Ratih Delio Rakhmadian, Meidi Kurnia Ariani, and Musthika Jathiasih from the Department of Conservative Dentistry, Faculty of Dentistry, Jember University. The case report was published in the Formosa Journal of Multidisciplinary Research (FJMR), Volume 5 Issue 5, in 2026.
Published under the title Case Report: Management of Fractures in Anterior Teeth among Adolescents, the study highlights the importance of early treatment for traumatic dental injuries, especially among children and teenagers whose confidence and social interaction can be strongly affected by visible tooth damage.
According to the researchers, fractures in anterior teeth are among the most common dental injuries in adolescents because the upper front teeth are positioned more prominently than other teeth, making them highly vulnerable to impact during falls, sports accidents, or physical trauma.
The case involved a 13-year-old female patient who visited Jember University Dental Hospital after suffering a fractured upper left lateral incisor caused by a fall three years earlier. Although the patient no longer experienced pain at the time of examination, clinical and radiographic evaluations revealed severe internal damage.
The crown structure of the tooth had almost completely disappeared, leaving only the cervical third intact. Vitality tests showed the tooth was non-vital, while radiographic imaging confirmed pulp involvement and widening of the periodontal ligament. The patient was diagnosed with pulp necrosis accompanied by asymptomatic apical periodontitis.
Researchers explained that delayed treatment was a major factor behind the worsening condition. Even when pain disappears, trauma-related damage inside the tooth may continue to develop silently over time.
“Trauma to anterior teeth not only causes structural damage but also affects aesthetics, function, and the patient’s quality of life,” the research team from Jember University stated in the article.
The researchers used a detailed case report approach to document the patient’s treatment process from diagnosis through final restoration. Clinical examination included dental vitality tests, radiographic imaging, oral hygiene assessment, and evaluation of surrounding tissues.
Treatment was performed over several visits and began with root canal therapy to eliminate infection and preserve the tooth inside the oral cavity.
During the first phase, the dental team cleaned and disinfected the root canal system using the step-back technique with K-files. The procedure included irrigation with sodium hypochlorite (NaOCl), EDTA, and chlorhexidine solutions to remove bacteria, dead tissue, and debris from the canal.
After the cleaning process was completed, the root canal was sealed using gutta-percha with the lateral condensation technique. Researchers emphasized that proper sealing is essential to prevent bacterial leakage and reinfection.
Four months after the endodontic treatment, the next stage focused on structural rehabilitation using a fiber post. The researchers selected a fiber post because its elasticity closely resembles natural dentin, allowing stress to be distributed more evenly and reducing the risk of root fracture.
Fiber posts also offer aesthetic advantages compared to conventional metal posts because they do not create dark shadows beneath the crown restoration, making them particularly suitable for anterior teeth.
After the fiber post was cemented into the root canal, the dental team rebuilt the tooth core using composite resin before preparing the final restoration with a porcelain fused-to-metal (PFM) crown.
The PFM crown was selected because it combines structural strength with natural-looking aesthetics. Researchers explained that full crown restorations provide better protection for teeth that have lost significant crown structure after trauma.
The final outcome showed positive clinical and aesthetic results. The patient reported no pain or discomfort, supporting tissues remained healthy, and chewing function was restored successfully. The appearance of the tooth was also significantly improved, helping restore the patient’s confidence.
The study highlights that successful treatment of traumatic dental injuries depends not only on root canal therapy but also on the quality of the final restoration. Proper coronal sealing, structural reinforcement, and functional load distribution are critical factors in long-term treatment success.
The researchers also stressed the importance of public awareness regarding dental trauma management. Many parents and adolescents delay treatment because pain symptoms disappear over time, even though infection and tissue damage may continue progressing internally.
According to the study, untreated anterior tooth fractures can eventually lead to complications such as pulp necrosis, bacterial infection, and inflammation of tissues surrounding the tooth root.
The findings carry important implications for dentistry, particularly in pediatric and adolescent dental trauma management. Modern restorative techniques combining endodontic treatment and aesthetic rehabilitation may help preserve natural teeth for longer periods while improving patient quality of life.
The research is also relevant for dental practitioners, dental education institutions, and public health campaigns focused on early intervention and preventive dental care.
For future studies, the researchers recommend larger-scale investigations comparing the long-term effectiveness of fiber posts and metal posts. They also encourage research into newer restorative materials that provide improved durability, aesthetics, and long-term stability for traumatized teeth.
Author Profile
Ratih Delio Rakhmadian is a researcher and academic from the Department of Conservative Dentistry, Faculty of Dentistry, Jember University. Her areas of expertise include endodontics, restorative dentistry, and post-traumatic dental rehabilitation. This study was co-authored by Meidi Kurnia Ariani and Musthika Jathiasih from the Faculty of Dentistry, Jember University.
Source
Ratih Delio Rakhmadian, Meidi Kurnia Ariani, and Musthika Jathiasih. Case Report: Management of Fractures in Anterior Teeth among Adolescents. Formosa Journal of Multidisciplinary Research (FJMR), Vol. 5 No. 5, 2026, pp. 1387–1398.
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