Consequences of tooth luxation associated with complicated crown fracture: a case report. 2020

Natália Mello Santos, and Rafael Massunari Maenosono, and Raquel Zanin Midena, and Franciny Querobim Ionta, and Gabriela Cristina Oliveira, and Priscilla Santana Pinto Gonçalves, and Daniela Rios

The objective of this clinical case report is to describe the late treatment performed in a 10-year-old patient who suffered a complicated crown fracture associated with luxation of the maxillary left central incisor. The patient-s parents reported that the patient fell and was immediately taken to a hospital, where radiographs, splinting, and suturing were performed and an anti-inflammatory prescription was provided, but no treatment was given for the exposed pulp. The parents and patient sought treatment at a pediatric dentistry clinic 16 days post-trauma. The clinical examination revealed the presence of a left central incisor with a fracture of enamel and dentin involving the pulp, which was necrotic, and a splint extending from the right lateral incisor to the left lateral incisor. However, it was not possible to diagnose the type of luxation that had occurred. The fractured incisor was treated with periodic changes of calcium hydroxide dressing for apexification for 10 months, and the root was subsequently obturated with gutta percha and root canal sealer. The tooth fragment was stored in physiologic solution during this time. After obturation, tooth darkening was observed, and LED-assisted tooth bleaching was accomplished prior to reattachment of the fractured fragment. The tooth was reexamined every 6 months. Two years after the traumatic event, the left central incisor was infraoccluded in relation to the right central incisor. A radiograph confirmed ankylosis of the traumatized tooth. When trauma affects the enamel, dentin, pulp, and supporting tissues, the prognosis can be unfavorable even when late treatment is adequate, especially when a tooth in a growing patient has points of ankylosis.

UI MeSH Term Description Entries
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003442 Crowns A prosthetic restoration that reproduces the entire surface anatomy of the visible natural crown of a tooth. It may be partial (covering three or more surfaces of a tooth) or complete (covering all surfaces). It is made of gold or other metal, porcelain, or resin. Dental Crowns,Crown, Dental,Crowns, Dental,Dental Crown,Crown
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012390 Root Canal Therapy A treatment modality in endodontics concerned with the therapy of diseases of the dental pulp. For preparatory procedures, ROOT CANAL PREPARATION is available. Therapy, Root Canal,Canal Therapies, Root,Canal Therapy, Root,Root Canal Therapies,Therapies, Root Canal
D014082 Tooth Fractures Break or rupture of a tooth or tooth root. Fracture, Tooth,Fractures, Tooth,Tooth Fracture
D014084 Tooth Avulsion Partial or complete displacement of a tooth from its alveolar support. It is commonly the result of trauma. (From Boucher's Clinical Dental Terminology, 4th ed, p312) Avulsed Tooth,Dislocation, Tooth,Tooth Luxation,Avulsion, Tooth,Avulsions, Tooth,Dislocations, Tooth,Luxation, Tooth,Luxations, Tooth,Tooth Avulsions,Tooth Dislocation,Tooth Dislocations,Tooth Luxations,Tooth, Avulsed
D014092 Tooth Root The part of a tooth from the neck to the apex, embedded in the alveolar process and covered with cementum. A root may be single or divided into several branches, usually identified by their relative position, e.g., lingual root or buccal root. Single-rooted teeth include mandibular first and second premolars and the maxillary second premolar teeth. The maxillary first premolar has two roots in most cases. Maxillary molars have three roots. (Jablonski, Dictionary of Dentistry, 1992, p690) Root, Tooth,Roots, Tooth,Tooth Roots
D019228 Tooth Crown The upper part of the tooth, which joins the lower part of the tooth (TOOTH ROOT) at the cervix (TOOTH CERVIX) at a line called the cementoenamel junction. The entire surface of the crown is covered with enamel which is thicker at the extremity and becomes progressively thinner toward the cervix. (From Jablonski, Dictionary of Dentistry, 1992, p216) Crown, Tooth,Crowns, Tooth,Tooth Crowns
D020254 Tooth Ankylosis Solid fixation of a tooth resulting from fusion of the cementum and alveolar bone, with obliteration of the periodontal ligament. It is uncommon in the deciduous dentition and very rare in permanent teeth. (Jablonski's Dictionary of Dentistry, 1992) Ankylosis, Dentoalveolar,Ankylosis, Tooth,Dentoalveolar Ankylosis,Ankylosis of Teeth,Dental Ankylosis,Ankyloses, Dental,Ankyloses, Dentoalveolar,Ankyloses, Tooth,Ankylosis, Dental,Dental Ankyloses,Dentoalveolar Ankyloses,Teeth Ankyloses,Teeth Ankylosis,Tooth Ankyloses

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