Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6298
Peer-review started: December 25, 2021
First decision: February 8, 2022
Revised: February 21, 2022
Accepted: April 27, 2022
Article in press: April 27, 2022
Published online: June 26, 2022
Complicated crown-root fracture is considered a severe dental trauma and is unlikely to heal without treatment. Usually, dentists have to remove the loose coronal fragment of the fractured tooth and treat the remaining part with multidisciplinary approaches. However, we observed spontaneous healing of fracture in two pediatric cases with a history of complicated crown-root fractures over 4 years ago.
In case 1, a 12-year-old boy complained of pain at tooth 11 following an accidental fall 1 d ago. Clinical examination showed a crack line on the crown of tooth 11. Cone beam computed tomography (CBCT) images of tooth 11 showed signs of hard tissue deposition between the fractured fragments. The patient recalled that tooth 11 had struck the floor 1 year ago without seeking any other treatment. In case 2, a 10-year-old girl fell down 1 d ago and wanted to have her teeth examined. Clinical examination showed a fracture line on the crown of tooth 21. CBCT images of tooth 21 also showed signs of hard tissue deposition between the fractured fragments. She also had a history of dental trauma 1 year ago and her tooth 11 received dental treatment by another dentist. According to her periapical radiograph at that time, tooth 21 was fractured 1 year ago and the fracture was overlooked by her dentist. Both of these two cases showed spontaneous healing of complicated crown-root fractures. After over 4 years of follow-up, both fractured teeth showed no signs of abnormality.
These findings may provide new insights and perspectives on the management and treatment of crown-root fractures in children.
Core Tip: Crown-root fracture is a severe dental trauma involving the enamel, dentin, cementum, and periodontal ligament. The mobile coronal fragment usually needs to be removed or reattached with bonding agent depending on the extent of the injury. Spontaneous healing with hard tissues has been rarely reported in crown-root fracture so far. In this report, we present two clinical cases with spontaneous healing of complicated crown-root fractures of permanent central incisors in children with over 4 years of follow-up, which may provide new insights and perspectives on the management and treatment of crown-root fractures.