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active 2 years, 5 months ago
Dental Trauma

Case based discussion about dental trauma

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Tooth Avulsion

  • This topic has 3 replies, 3 voices, and was last updated 2 years, 5 months ago by Lee Ming Chan.
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    • 2022-11-14 at 10:06 pm #2320
      Lee Ming Chan
      Participant

      History:
      ABOUT THE ACCIDENT
      1. How did the accident occur?
      2. When and where?
      3. What are the specifics of injury: Type of object contacted; Direction; Identify abuse/violence

      ABOUT THE PATIENT
      1. Where is the Injury?
      2. Any bleeding at time of accident?
      3. What has been done?
      4. Loss of consciousness, amnesia, headache, vomit, blur vision, confuse, seizure?
      5. What symptoms pt is having?
      7. Where is the tooth? How was it brought to the clinic from time of accident?
      6. Has the child swallow the tooth?

      MEDICAL HISTORY
      1. Medication
      2. Allergies
      3. Bleeding disorder
      4. Tetanus status

      MANAGEMENT
      Treatment option
      1. Tooth replantation.
      2. Partial denture
      3. Cantilever bridge
      4. Implant when patient has reach adulthood.

      Best option may be tooth replantation. After rinsing the tooth root with saline, place the tooth back into the socket. Stabilize the tooth by placing flexible splint for 2 weeks. Root canal treatment is indicated after 7-10 days or when tooth shows signs and symptoms of necrosis.

      • 2022-11-14 at 10:11 pm #2321
        Justin Tan
        Participant

        Awesome! Mind explaining more about the minimum age suitable for implant placement?

      • 2022-11-14 at 10:21 pm #2322
        Lee Ming Chan
        Participant

        Great question. An osseointegrated implant would behave much like an ankylosed primary tooth, with the same lack of alveolar growth and dental eruption.
        Found from the 1 article stating implants placed after age 15 for girls and age 18 for boys have the most predictable prognosis. Implants placed before these ages may not be permanent and may have to be re-implanted [1].

        Another study mentioned the appropriate age for osseointegrated dental implant placement is very unique, since the end of facial growth is widely variable and has to be determined by means of cephalometric radiograph superimposition for each patient [2]

        1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3800426/
        2. https://www.researchgate.net/publication/284070775_What_is_the_appropriate_age_for_dental_implant_placement

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