Multidisciplinary Management of A Nasally Displaced Dilacerated Tooth Following Early Childhood Dental Trauma: A Case Report

Abstract

Traumatic dental injury (TDI) to primary teeth is common in childhood and often not given sufficient attention by parents. Many parents think primary teeth are only transient before permanent successors replace them. One of the serious consequences of TDI to primary teeth is tooth dilaceration of the permanent successor teeth. Luxation injuries, such as intrusion and avulsion to the primary teeth, can give rise to tooth dilaceration of the permanent successor teeth, that some cannot erupt. This case describes dental management of a 12-year-old girl who was concerned about her dental aesthetics because of failed eruption of one of her permanent central incisors. She had a history of tooth avulsion during her childhood to one of her upper front teeth. Parents gave little thought to it and did not seek any treatment, thinking it was only a primary tooth. Investigations showed an unerupted dilacerated right permanent central incisor with the crown nasally orientated. The affected tooth was surgically extracted, the spaces between the maxillary anterior permanent teeth were redistributed orthodontically and the missing tooth in the arch was replaced with a fixed prosthesis. This case highlights the impact of early childhood TDI and one of its dental consequences. Multidisciplinary management approach allows proper discussion between dental specialties on the feasibility of various treatment options and selecting the most suitable treatment to satisfy the patient’s needs from the aesthetic and functional perspectives.