Pulp health and calcific healing of a complicated crown-root fracture with additional root fracture in a maxillary incisor: A case report.

Abstract

Background: Complicated crown-root fracture (CRF) involves severe injury to the crown, root, and pulp, and may be accompanied by multiple root fractures. The loss of a tooth has lifelong consequences for children and teenagers, but the maintenance of pulp health and the calcific healing of multiple root fractures are rarely reported in the literature.

Case summary: This case reports healing of a permanent tooth with complicated crown-root and additional root fractures, in which pulp health was maintained. A 10-year-old girl fell and fractured the root of her maxillary left central incisor at the cervical level. After the coronal fragment was repositioned, the tooth was splinted until the tooth was no longer mobile, 2 years later. Eight years after treatment, the tooth has remained asymptomatic with vital pulp and localized gingival overgrowth. Cone-beam computed tomography revealed not only calcified healing of the CRF but also spontaneous healing in an additional undiagnosed root fracture. The fracture line on the enamel could not be healed by hard tissue and formed a groove in the cervical crown. It was speculated that the groove was related to the localized gingival overgrowth.

Conclusion: This case provides a clinical perspective of the treatment of a tooth with a complicated CRF and an additional root fracture.