Aim To report different patterns of root fracture healing in adjacent maxillary central incisors with distinct post-treatment outcomes. Summary To describe the case of a 12-year-old girl who presented with an avulsed coronal fragment of tooth 11 and root fractures in the middle thirds of teeth 11 and 21. Four months after initial treatment, she was referred for specialized endodontic care. Tooth 11 presented no clinical or radiographic signs of pulp breakdown. However a sinus tract was found related to the middle root third of tooth 21, indicating pulp necrosis in the coronal fragment. The coronal fragment was root filled and periapical surgery was performed to remove the apical fragment. Twelve months after the clinical procedures and 16 months after trauma, hard tissue healing was evident in tooth 11 region. Bone healing was also satisfactory in the periapical region of tooth 21. Key learning points Even adjacent teeth may display different reaction patterns after trauma. The prognosis of root fractures is variable and different clinical approach may be required to preserve teeth with fractured roots.416532537