Healing and Skeletal Development Outcomes of a Complex Case Involving Complicated Crown-Root Fracture and Luxation Injuries With a 4-Year Follow-Up.

Abstract

The management of complicated crown-root fractures of immature permanent teeth requires a multidisciplinary approach to address biological, functional, and aesthetic concerns. A 10-year-old boy suffered a complicated crown-root fracture of tooth 11, an uncomplicated crown fracture, subluxation and pulp necrosis of tooth 21 and subluxation of tooth 22 after falling from a bicycle. The treatment for tooth 11 involved maintaining pulp vitality with partial pulpotomy and re-attachment of the crown-root fragment after modified crown-lengthening surgery. Treatment for tooth 21 included a flexible splint, root canal therapy, placement of an apical barrier and resin composite restoration. During the 4-year follow-up, the root of tooth 11 fully developed, and the patient remained asymptomatic and achieved an aesthetically acceptable outcome. Conservative partial pulpotomy followed by adhesive reattachment of the tooth fragment with the modified crown lengthening technique can be a viable treatment for complicated crown-root fractures in immature permanent teeth.