Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2022; 10(18): 6298-6306
Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6298
Spontaneous healing of complicated crown-root fractures in children: Two case reports
Zi-Ling Zhou, Lei Gao, Shu-Kai Sun, Hong-Shi Li, Cai-Di Zhang, Wen-Wen Kou, Zheng Xu, Li-An Wu
Zi-Ling Zhou, Lei Gao, Shu-Kai Sun, Cai-Di Zhang, Wen-Wen Kou, Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
Hong-Shi Li, Institute of Stomatology, The General Air Force Hospital of PLA, Beijing 110142, China
Zheng Xu, The Center for Pediatric Dentistry, Department of Pediatric Dentistry, University of Washington, Seaatle, WA 98115, United States
Li-An Wu, Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
Author contributions: Zhou ZL, Gao L and Wu LA performed the dental treatment; Zhou ZL, Sun SK, Zhang CD and Kou WW reviewed the literature, and contributed to the drafting of the manuscript; Xu Z, Li HS and Wu LA were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Supported by National Natural Science Foundation of China, No. 81771095; Shaanxi Provincial Key R&D Program, China, No. 2021KWZ-26; and State Key Laboratory of Military Stomatology, No. 2020ZA01.
Informed consent statement: Informed written consent was obtained from the patients’ parents for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-An Wu, PhD, Professor, Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University, No. 145 Changle West Road, Xincheng District, Xi’an 710032, Shaanxi Province, China. lianwu@fmmu.edu.cn
Received: December 25, 2021
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
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

These findings may provide new insights and perspectives on the management and treatment of crown-root fractures in children.

Keywords: Dental trauma, Complicated crown-root fracture, Spontaneous healing, Children, Case report

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.