Long-term conservative management of a mid-root fracture in an immature maxillary central incisor: a 12-year follow-up case report
Year: 2026
Type: article
Study design: Case Report
Abstract: Background: Traumatic injuries to immature permanent teeth present a clinical challenge because treatment decisions may influence continued root development, pulp health, and long-term tooth survival. Conservative management aimed at preserving pulpal and periodontal tissues is an important consideration when clinical and radiographic findings indicate continued biological healing. Case presentation: A 7-year-old boy presented with traumatic displacement and a mid-root fracture of the immature maxillary right central incisor (#11) following a fall. The tooth was repositioned and stabilized with a flexible wire-composite splint. During follow-up, the tooth sustained reinjury; however, conservative management was continued because the tooth remained clinically asymptomatic and continued to respond positively to pulp sensibility testing, with no evidence of pulpal or periapical pathology. Serial clinical and radiographic examinations over 12 years demonstrated continued root development, progressive calcified healing at the fracture site, and maintenance of periodontal and tooth function. Outcome: At the 12-year follow-up, tooth #11 was asymptomatic, maintained normal crown color and function, and demonstrated a positive response to pulp sensibility testing. Radiographic examination showed complete root development with apical closure, calcified healing at the fracture site, and a normal-appearing periodontal ligament space. No evidence of pulp necrosis, inflammatory or replacement root resorption, or periapical pathology was observed. Conclusion: This case demonstrates the potential for continued root development and favorable long-term healing following conservative management of a root-fractured immature permanent tooth. The findings support careful preservation of pulpal and periodontal tissues when clinical and radiographic findings indicate ongoing biological healing. Long-term follow-up is essential to detect late complications and to guide treatment decisions while avoiding unnecessary intervention.
Source: Frontiers in Pediatrics
Authors: Ling Xie, Yongjie Wei
Institution: Anhui Medical University
Language: English
Topic: Dental Trauma and Treatments
Subfield: General Dentistry
Field: Dentistry
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223097485