Crown-root fracture with pulp exposure: a case report with 16-year follow-up

A 12-year-old boy presented for dental care 35 days after he fell from his bicycle. Clinical and radiographic examinations revealed a longitudinal crown-root fracture with pulp exposure in the maxillary left central incisor. The radiograph also suggested necrosis of the maxillary right central incisor. Urgent treatment of the left central incisor involved gingivectomy followed by autogenous bonding of the tooth fragment with self-curing composite resin. Immediately after bonding, coronal access was prepared, chemical and mechanical preparation was completed, and a calcium hydroxide intracanal dressing was placed. One week after the initial appointment, endodontic treatment was initiated in the right central incisor. The root canal of the maxillary left central incisor was maintained with calcium hydroxide paste (replaced at 45-day intervals) for 1 year and then definitively obturated. At the 16-year follow-up, satisfactory periodontal, esthetic, and clinical conditions were observed, and a radiograph revealed no resorption or periapical changes.