Management of multiple traumatized teeth

Abstract

Introduction: Traumatic dental injuries to the teeth and supportingstructures have a peak incidence at 9–10 years old for thepermanent dentition. The management of avulsed central incisors,complicated crown-root and uncomplicated fractures of lateralincisors in a 13 year old boy is presented in this poster.Clinical management: The patient presented with avulsed maxillarycentral incisors, a complicated crown-root fracture of tooth 22 andan uncomplicated crown fracture of tooth 12. In order to maintainpulp vitality, restore normal aesthetics and function, and the losttooth structure for the uncomplicated crown fracture of the rightmaxillary lateral incisor it was restored using composite resin. Thecomplicated crown-root fracture of the left lateral incisor (tooth22) was treated with a Cvek pulpotomy. Root planning andmaintenance of proper oral hygiene brought about the resolutionof the pseudo-pocket caused by the crown-root fracture. Themissing tooth structure was restored using composite resin. Theavulsed maxillary central incisors were not recovered at the time ofthe accident. A modified Nance palatal appliance with acrylic teethwas used to replace the missing teeth. This however, is only theshort term treatment, the definitive treatment plan will probably involve orthodontic treatment to align his teeth, porcelain crownsand dental implants, which can only be considered once growth hasceased.Conclusion: Management of dental trauma should be minimallyinvasive and based on sound diagnosis including both short termand long-term treatment options.