Central incisor: endodontic, restorative and prosthodontic of a complicated radicular fracture in tooth traumatized twice / Vispi S, Mascella E, Petrulio S, Falco C, Ndokaj A, Solimena A

**Aim:** crown-root fractures extending apically to the gingival margin and/or bone represent rare and complex dental injuries, whose management is especially challenging in cases of recurrent trauma. Conservative treatment through adhesive techniques offers a minimally invasive solution, enabling both functional and aesthetic recovery. The primary goal is to preserve the tooth in situ as long as possible, maintaining tissue trophism and postponing, if needed, future replacement therapy - potentially implant-supported - considering the young age of the patient (9 years old). **Methods:** a 9-year-old patient presented with a traumatic crown-root fracture on the 2.1 element, with the fracture line extending subgingivally from the cervical third of the palatal surface. The fragment was repositioned and endodontic treatment performed. A second trauma caused fragment detachment, requiring surgical reattachment using adhesive techniques. A second root canal was performed, and orthodontic extrusion was required to gain adequate crown length. A provisional crown was then placed. **Results:** at 8-month follow-up, the tooth showed reduced mobility and satisfactory healing of the pericoronal tissues. A definitive adhesive crown restoration in direct composite was performed as an alternative to a prosthetic crown due to financial constraints. **Conclusions:** adhesive and minimally invasive strategies enabled the functional and aesthetic rehabilitation of a fractured tooth in a pediatric patient, preserving most of the tooth structure and supporting.