A young patient fractures her maxillary central incisors with dentin exposure but no pulp involvement. What is the restoration of choice?

Correct answer: D. Direct composite restoration

• A. Indirect restorations require more tooth reduction and multiple appointments with no meaningful advantage here.
• B. Crowns are grossly over-treatment for a fracture with only dentin exposure and would risk pulpal injury in a tooth with a large chamber.
• C. Veneers require tooth reduction and are contraindicated in a young patient with an immature gingival contour and large pulp.
• D. CORRECT. DIRECT COMPOSITE is the treatment of choice for an uncomplicated crown fracture in a young patient. It is conservative (essentially no additional tooth removal), immediate, esthetic, repairable, reversible, and inexpensive — all critical in a patient with a large pulp chamber, incompletely formed roots, an immature gingival margin, and ongoing alveolar growth. Place a liner or base if dentin is deep, and monitor pulp vitality over time.

Note: If the fractured fragment is available and intact, reattachment with adhesive bonding is an excellent conservative option — ask the patient to bring it in saline or milk.