25-year-old female patient presented to the dental clinic with dentoalveolar trauma because of an accidental fall.
Adult dentoalveolar trauma is quite common during sports activities and road traffic accidents. A 25-year-old female presented to the dental clinic with dentoalveolar trauma, 24 hours after an accidental fall. Examination showed contusion of the lower lip, uncomplicated coronal fracture of the upper incisors and extrusive luxation of the upper and right central incisor.
The patient was advised an x-ray and cone beam computed tomography (CBCT). The imaging confirmed extrusive luxation of the upper right central incisor and alveolar fracture of the upper anterior buccal plate.
On the first visit, the dentist repositioned the upper right central incisor within its socket. Moreover, splinted the traumatised teeth to the neighbouring teeth with a wire and composite material. The coronal fractures were also reconstructed with composite on the same visit. The patient was prescribed antibiotic treatment with amoxicillin 875 mg and clavulanic acid 125 mg with analgesia in the form of ibuprofen 600 mg.
Follow-up
The patient was called back after three weeks for vitality testing using a tetrafluoroethane spray. However, the test yielded negative results with both upper in both upper central incisors and right later incisor. Endodontic treatment of the teeth was carried out on the teeth. Similarly, secondary pulp necrosis caused discolouration of the teeth. Therefore, internal bleaching of the upper lateral incisor was also done using 35% hydrogen peroxide.
However, the internal bleaching lasted for only four weeks after, therefore, porcelain veneers were prepared for all four upper incisors to improve aesthetics. After the clinical and aesthetic condition of the patient were stabilised, CBCT evaluation of the alveolar bone fractures after 5 months confirmed healing of the buccal plate.
The patient remained asymptomatic even after two years, with no signs of root resorption or ankylosis of the damaged teeth.
References
Treatment and restoration of adult dentoalveolar trauma: A clinical case report https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5149104/
