Front tooth repair: restoring a chipped or broken central incisor and choosing the right method

What determines how a front tooth is repaired?

The method of repairing a front tooth depends above all on whether the fracture involves only enamel, also involves dentine or has exposed the pulp, and on how much healthy tissue remains. The International Association of Dental Traumatology (IADT) classifies crown fractures in permanent teeth by their depth and gives different management recommendations for each type (Bourguignon et al., 2020).

Before the repair, the dentist examines the tooth, tests the pulp response and usually takes an intraoral X-ray, because the injury may also have loosened the tooth or fractured its root. The bite, habits such as nail-biting, the tooth’s colour and the patient’s age also matter, particularly if the root is still developing.

This article concerns restoration, meaning what happens after an injury or after a tooth has chipped. A separate article on a knocked-out tooth explains what to do in the first few minutes after a tooth is knocked out or broken and when to go to a hospital emergency department (SOR).

Fracture size and repair options: an overview

The less tissue has been lost, the simpler and more conservative the repair can be. The table sets out typical situations based on IADT guidelines and studies of restorations; the dentist makes the final choice after an examination and an X-ray.

Repairing a broken tooth with composite: what does it involve and how long does it last?

Repairing a broken tooth with composite involves bonding a tooth-coloured material to enamel and dentine. The dentist applies it in layers and shapes it directly in the mouth, then light-cures and polishes it. This type of repair usually requires no removal of healthy tissue beyond smoothing the fracture edges.

In a meta-analysis of 21 clinical studies, the estimated success rate without replacement after 10 years was 90% for restorations of a front tooth’s corner (Class IV) and 95% for smaller restorations on the surfaces between teeth (Class III). Fracture was the main reason for replacing corner restorations (Heintze et al., 2015). Bevelling the enamel at the edge of the defect was associated with less loss of the restoration’s shape through wear.

Most studies in this meta-analysis began before 2001, so they concern older materials. Chipped composite can usually be repaired with the same material without replacing the entire restoration.

Flow injection: when is this technique useful?

The injection technique involves filling a mould that reproduces the previously planned tooth shape (a wax-up) with a highly filled flowable composite, which is cured directly on the tooth. In a 2021 case report, it allowed the wax-up’s shape to be reproduced precisely, but after a year the restorations became discoloured and needed repolishing (Ypei Gia et al.).

A 2025 systematic review of 31 studies found that highly filled flowable composites have good optical properties and good initial results with the injection technique, but weaker mechanical properties than medium-viscosity composites (Tzimas et al.). The authors advise against using them for extensive defects, in areas under heavy load, with tooth wear or with grinding, and recommend careful patient selection.

In practice, the injection technique is particularly useful when several teeth need a similar change of shape based on one design. For a single fracture subject to heavy loading, the dentist may choose layered composite.

Can a broken piece of tooth be reattached?

A broken piece of tooth can often be reattached: the IADT guidelines state that an intact fragment is bonded back to the tooth after rehydration in water or saline for 20 minutes (Bourguignon et al., 2020). After an injury, it is therefore worth finding the fragment and taking it to the dentist in water or saline so that it does not dry out.

A reattached fragment has the advantage of retaining the natural colour, shape and sheen of your own enamel, but it does not always stay in place permanently. In a meta-analysis of 6 studies, fragments detached in an average of 20% of cases. The risk of loss was higher than for composite restorations and lowest for fractures without pulp exposure with additional reinforcement; the certainty of this evidence was rated very low (Tewari et al., 2024).

If the fragment detaches or becomes discoloured, the tooth is usually restored with composite. Reattaching a fragment therefore does not rule out other methods in future.

When is a veneer or crown chosen instead of composite?

The dentist usually suggests a veneer or crown when a large amount of tissue has been lost, the tooth is discoloured or it has already been restored with composite several times. A veneer covers the front surface of the tooth, whereas a crown covers the entire tooth but requires considerably more tissue to be removed.

Both methods have good results in studies. A 2025 review reported ceramic veneer survival of 93.7 to 96.8% after 10.4 years of follow-up (Klein et al.), while a 2026 review reported 5-year survival of 98.5% for single monolithic lithium disilicate crowns, with similar results for most materials in front and back teeth (Pjetursson et al.).

When a fracture has exposed the pulp in a mature tooth and a post in the canal is needed to retain a crown, the IADT guidelines identify root canal treatment as the preferred approach. The article on restoring a tooth after root canal treatment explains how such teeth are rebuilt.

Front tooth repair in children and teenagers: what is different?

In children and teenagers, keeping the pulp alive is the main priority, because this allows roots that have not yet finished developing to continue growing. For a fracture exposing the pulp in such a tooth, IADT guidelines recommend partial removal or capping of the pulp to support continued root development (Bourguignon et al., 2020).

A broken tooth then needs follow-up: for an enamel and dentine fracture, the IADT recommends reviews after 6 to 8 weeks and after a year, with additional reviews at 3 and 6 months if the pulp was exposed. At these appointments the dentist checks whether the pulp is alive, because injury can damage it after a delay, particularly if the tooth was also loosened.

How much does central incisor repair cost, and what does the NFZ cover?

The cost of repairing a central incisor depends on the method, the size of the defect and whether pulp treatment is needed. In the clinic’s price list, “odbudowa zęba metodą flow injection” (tooth restoration using flow injection) costs 800 zł, “Bonding 1 zęba” (bonding for one tooth) 1 000 zł, “Wypełnienie trzypowierzchniowe” (three-surface filling) 400 zł, “Wypełnienie więcej niż trzech powierzchni” (filling involving more than three surfaces) 500 zł, “Licówka pełnoceramiczna” (all-ceramic veneer) 3 000 zł and “Korona pełnocyrkonowa” (full zirconia crown) 3 000 zł. The dentist sets the final scope and cost after the examination, and prices may change.

Adults are entitled to fillings under the NFZ, Poland’s National Health Fund; in the upper and lower front teeth from canine to canine, chemically cured composite may be used. Children and young people under 18 are additionally entitled to light-cured composite in incisors and canines and to the service “całkowite opracowanie i odbudowa zniszczonego kąta w zębach siecznych” (complete preparation and restoration of a damaged incisal corner), covering a broken corner of a permanent tooth. Veneers and crowns are not funded (Ministry of Health regulation, t.j. Dz.U. 2025 poz. 615, legal status as of 24 October 2026).

How it works at DentalBlue

At DentalBlue in Białystok, front tooth repairs form part of restorative and cosmetic dentistry; the price list includes flow injection restorations, bonding, veneers and crowns. Intraoral and panoramic X-rays are taken in the clinic’s own radiology unit. Patients with pain after an injury can attend a “Wizytę z bólem” (visit in pain, 340 zł), which includes a panoramic X-ray, consultation, examination and pain relief. The clinic is open Monday to Friday from 8:00 to 20:00 and on Saturdays from 8:00 to 16:00. An appointment can be arranged by phone.