Trauma of treatment planning.[7] There are various treatment modalities

Trauma with accompanying fracture of
a permanent incisor is a terrible experience for the young patient and creates
a psychological impact on both the parents and children.2 If the
injury involves the loss of extensive tooth structure, it alters the child’s
appearance and makes him the target for teasing by peers.

Treatment objectives may vary
depending on the age of the patient, socioeconomic status of the patient and
intraoral status at the time of treatment planning.7 There are
various treatment modalities for restoration of fractured teeth like composite
restoration, fixed prosthesis, reattachment of the fracture fragment (if
available) followed by post and core supported restorations.7-9
Common restorative management such as full-coverage restoration or  laminate veneers can be considered after
multiple fragment rebonding/ composite resin restorations have been done and
this option is no longer functional. These methods might tend to sacrifice the
healthy tooth structure and challenge the dental professional to match with the
adjacent healthy teeth. 10

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Management of the young patient with
anterior tooth fracture provides a great challenge to the dental professional
both from an aesthetic and functional perceptive. The predictable esthetic
restoration of the broken incisal edge of maxillary incisors is a demanding and
technique sensitive procedure. Its success is dependent on clinician skills and
knowledge and also on adhering to a systematic and problem-solving approach.6
A logical method is used to build-up morphologically correct composite
restorations by careful selection of composite shades, tints and opaquers in
accurate combinations, an illusion of varying translucencies and opacities
become visible over natural tooth structure.11

These anterior composite restorative
materials offer a cost-effective management alternative among young adults with
fractured dentition, where esthetics is a major concern. With further
improvements in bonding chemistry, the success rate of composites is speculated
to improve.9 A good polishing system including polishing paste,
cups and wheels is recommended to achieve appropriate luster.

In the present case, an innovative
technique which includes both direct and indirect method of restoring was designed
by using polyvinyl siloxane rubber base impression material (putty) as a
template. This method is simple, quick and economic, when compared to other
invasive procedures. The usage of the polyvinyl siloxane rubber template offers
incremental layering of the composite restorative material, optimal depth of
curing, accurate reproducibility of the morophological contours and minimal
polishing and finishing procedures.12,13