Vital Pulp Preservation and Restorative Treatment for Young Permanent Incisors with Complicated Crown-Root Fractures: A Case Report.

Abstract

This study reports a case of complicated crown-root fractures of the maxillary central incisors (teeth 8 and 9) in a 10-year-old boy. Vital pulpotomy and iRoot BP Plus capping were performed to protect the pulp. The fractured crown fragments were used to restore the tooth morphology, and the esthetics and function of both central incisors were restored. The roots of the affected teeth continued to develop normally. Twenty-five months after the initial treatment, the patient suffered another trauma, resulting in a second dislodgement of the fractured crown of the left maxillary central incisor. Given the structural integrity of the fractured crown, reattachment was performed again to reshape the tooth, thereby restoring its appearance to the greatest extent possible. After a 40-month follow-up, the esthetics and function of teeth 8 and 9 remained satisfactory. Normal anterior occlusion was established, and the treatment outcome was highly appreciated by the patient and his parents. This case provides clinical detail useful for managing complex crown and root fractures caused by multiple traumas in young permanent teeth, emphasizing the importance of pulp preservation, conservative restoration, and preventive measures.