TRAUMA MANAGEMENT
60 year old otherwise healthy male got caught up in an altercation with his step daughter’s boyfriend. He came out with some facial trauma (see displaced central incisor #8) and the boyfriend got jail time. Anyway…he presented to our office 10 days post trauma; not an ideal situation as we would rather have seen this patient as close to the traumatic incident as possible; this is due to the granulation tissue already being formed in the space that is left from the tooth being displaced. We would have liked to take a CBCT to evalated the alveoloar bone for any fractures; however, the patient declined.
The timeline for management of this case is as follows:
- Reapproximation of the tooth using digital pressure and held in place with a flexible splint inclusive of the 2 adjacent teeth on either side for anchorage. the flexible splint will be removed within 10-14 days with NO endodontic therapy rendered immediately. This is because there is damage to the periodontium (support apparatus for the tooth) and we want to give it time to heal before initiating endodntic therapy.
- Patient was placed on 100mg Doxycycline 2x/day for 10 days; may help prevent root resoption. Pt. was also given an antibacterial mouthrinse to be used during the same time span.
- At 10-14 days, endodontic treatment will be rendered and the spling removed.
- Follow-up and recall as necessary to evaluate for stability of the tooth and monitoring for ankylosis (replacement resorption).
Pre-operative radiograph and photo on top, Post-operative on bottom. Stay tuned for the next part in the series for this case!
