A patient with methamphetamine-associated caries and poor oral hygiene presents with an Ellis Class IV fracture of a maxillary central incisor. What is the most appropriate treatment?

In a patient with active methamphetamine-associated caries and poor oral hygiene, the immediate and most appropriate treatment is direct composite resin restoration. Before committing to an extensive or irreversible restoration such as a veneer or crown, the patient's oral hygiene must be stabilized and active caries arrested. Crowns and veneers are costly, require significant tooth reduction, and may fail quickly if caries activity is not controlled. Composite resin is reversible, conservative, and appropriate during the disease control phase of treatment.