Introduction: Vertical root fracture is one of the conditions prevalent in endodontically treated teeth. The treatment options include extraction of the fracture fragment or the affected tooth as a whole. This case report highlights the successful management of vertical root fracture in an endodontically treated mandibular first premolar.
Method: Surgical intervention was initiated, and a full-thickness flap was elevated. The separated fracture segment was safely retrieved, and the existing caries were removed and then reattached to the main fragment with the help of a titanium screw. The tooth was rehabilitated with a composite resin core followed by a porcelain-fused metal crown and the patient was followed up for 7 years.
Result: The tooth was functional with evidence of new bone formation.
Conclusion: Reattachment of the fracture fragments with a titanium screw might be considered as an option for managing vertical root fracture cases with poor prognosis.
Keywords: Case report; composite resin; healing; screws; vertical root fracture.