Management of dental traumatic injuries to permanent dentition-an informed approach

Abstract

INTRODUCTION: Fractured, displaced, or avulsed teeth are the most commonly occurring dental traumatic injuries (DTIs) in children. These injuries cause pain, impair masticatory function, speech, and compromise esthetics, thus affecting the child’s overall quality of life. The child’s age, severity of injury, and appropriate treatment and follow up, using the recommended guidelines and procedures, are critical for successful treatment. CASE REPORT: A 9-year-old Chinese boy presented with avulsion and intrusion injuries to his permanent maxillary central incisors, 90-minutes following a fall at school. His medical history was noncontributory. Tooth 21 was re-implanted, and teeth 21 and 11 were treated endodontically with calcium hydroxide placed in the root canal. Consequently, tooth 21 exhibited external root resorption, and after 21 months only the cervical third of the root had remained. In the presence of the patients existing malocclusion teeth 11 and 21 were extracted as part of a multidisciplinary treatment plan with the option of using the lateral incisors to replace the central incisors and canines to replace the laterals. COMMENTS: Despite the availability of several management options, there appears to be no guaranteed outcome for DTIs. Each child is an individual with specific treatment needs, which necessitates a different treatment plan based on the type of traumatic injury encountered. This case highlights, that the treatment outcome patterns of DTIs are unpredictable and, a multi-disciplinary informed approach, as in this case, may result to a more predictable outcome.