Abstract
Introduction: Management of dental trauma in pediatric patients requires not only immediate intervention but also long-term follow-up regimen. Especially, avulsion of permanent teeth is the most serious injuries of the tooth, and replantation of teeth must be carried out immediately for good prognosis. Case Report: This article describes the treatment of four anterior maxillary permanent incisors of an 11-year-old boy with history of traumatic avulsion and delayed replantation. The avulsed teeth were kept in unclean and dry conditions for 5 h. The root canal treatment was carried out with mineral trioxide aggregate (MTA). After treatment, the patient was referred to the orthodontic department and two of replanted teeth were extracted orthodontically. The remained replanted teeth were stable and functional position during the four-year follow-up. However, one of teeth showed an excessive root resorption on the last radiographic examination.Conclusion: Although the risk of progressive root resorption and ankloysis is high, delayed replantation of avulsed teeth can be a best choice to avoid early tooth loss. To prevent the complications of delayed replantation, MTA might be used for root canal treatment. Thus, the level of alveolar bone can be preserved till the growth is completed.
Highlights
Management of dental trauma in pediatric patients requires immediate intervention and long-term follow-up regimen
One of the most serious dental injuries is avulsion which is characterized by the complete displacement of the tooth from its socket, causing damage to the supporting tissues [3]
If the avulsed tooth is exposed to a dry medium for long periods, it may cause the death of periodontal ligament (PDL) cells, which starts pathological resorption processes [7]
Summary
An appropriate emergent surgical care and longterm follow-up regimen is necessary to manage dental injuries in the pediatric population [1, 2]. After removal of triple antibiotic paste, the root canal treatment of maxillary right permanent central and lateral incisors (Tooth 11, 12) was completed with gutta-percha points Gutta percha points were removed from endodontically treated root canals of maxillary right permanent central and lateral incisors (tooth 11, 12) due to tooth mobility and the canal spaces were filled with MTA. Periapical radiograps were taken at six months followup and evident root resorption was shown on maxillary left central and lateral incisors (Tooth 21, 22) (Figure 5). In the 30-month follow-up, orthodontic brackets had been attached to the teeth in the maxillary dental arch and a periapical radiography revealed that there were no progressive root resorption on tooth #21 (Figures 9 and 10). The patient will be monitored till her growth is complete and appropriate treatment will be carried out if needed
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