Trauma-induced crown dilaceration of permanent maxillary central incisors: A case report with CBCT follow-up

Traumatic dental injuries to primary teeth may result in developmental disturbances in the permanent successors because of the close anatomical relationship between primary tooth apices and developing permanent tooth germs. Injuries occurring during crown formation may interfere with normal odontogenesis and lead to crown dilaceration. A 7-year-old healthy boy presented with abnormal eruption of the permanent maxillary central incisors. At 2.5 years of age, he had sustained avulsion of both primary maxillary central incisors and crown fractures of the primary lateral incisors, followed by extraction of residual root fragments under general anesthesia. Cone-beam computed tomography examination at 6.5 years revealed early abnormal crown morphology of the permanent maxillary central incisors. Follow-up imaging at 7 years confirmed bilateral crown dilaceration, more pronounced on the left side, while root morphology remained normal. Nine months after eruption, the left permanent central incisor developed extensive structural breakdown with pulpal exposure and was considered nonrestorable; therefore, extraction was performed. The contralateral incisor remained asymptomatic and continues under periodic follow-up. The findings were consistent with trauma-related crown dilaceration associated with injury during early crown mineralization. Preservation of Hertwig's epithelial root sheath may explain the normal root development despite severe coronal deformity. Cone-beam computed tomography provided valuable 3-dimensional information for diagnosis, longitudinal monitoring, and treatment planning. Early trauma to primary incisors may result in crown dilaceration of permanent successors. Cone-beam computed tomography contributed useful diagnostic information for evaluating crown morphology and planning clinical management in this case.