Zhou Zi-Ling, Gao Lei, Sun Shu-Kai, Li Hong-Shi, Zhang Cai-Di, Kou Wen-Wen, Xu Zheng, Wu Li-An
Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.
Institute of Stomatology, The General Air Force Hospital of PLA, Beijing 110142, China.
World J Clin Cases. 2022 Jun 26;10(18):6298-6306. doi: 10.12998/wjcc.v10.i18.6298.
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.
复杂冠根折被认为是一种严重的牙外伤,未经治疗不太可能愈合。通常,牙医不得不去除折断牙齿的松动冠部碎片,并采用多学科方法治疗剩余部分。然而,我们观察到两例儿童病例的骨折自发愈合,这两例病例发生复杂冠根折已有4年多的病史。
病例1,一名12岁男孩在1天前意外摔倒后诉说11号牙疼痛。临床检查显示11号牙冠部有一条裂纹线。11号牙的锥形束计算机断层扫描(CBCT)图像显示骨折碎片之间有硬组织沉积迹象。患者回忆1年前11号牙撞到地面,但未寻求任何其他治疗。病例2,一名10岁女孩在1天前摔倒,想要检查牙齿。临床检查显示21号牙冠部有一条骨折线。21号牙的CBCT图像也显示骨折碎片之间有硬组织沉积迹象。她1年前也有牙外伤史,当时她的11号牙由另一位牙医进行了治疗。根据当时她的根尖片,21号牙在1年前骨折,当时她的牙医忽略了该骨折。这两例病例均显示复杂冠根折自发愈合。经过4年多的随访,两颗折断的牙齿均未显示异常迹象。
这些发现可能为儿童冠根折的处理和治疗提供新的见解和观点。