IADR Abstract Archives
Four-Year Follow-Up of a Child With Impacted Dilacerated Incisor After Auto-Transplantation
Objectives: This case presents a four-year follow-up after the tooth transplantation of a patient with an impacted dilacerated incisor due to dental trauma in a child patient.
Methods:
9 year-old-male patient referred to our Department of Pediatric Dentistry at Marmara University due to disturbed eruption of maxillary incisor teeth as a his main complaint. His dental history revealed a severe fall from bicycle few years ago resulting facial and dental trauma while he had full primary dentition. At the first examination, 11 and 21 were erupted and crown of 21 was positioned towards vestibular side. Both 12 and 22 didn’t erupt yet. Panoramic and periapical radiographs revealed that 12 was below gingiva and maxillary 22 was positioned parallel to horizontal plane. 3D Volumetric Tomography was used in order to see detailed tooth positions. Severe dilaceration and malformation on the root of maxillary left lateral incisor was noticed.
In first step 11 and 21 were repositioned using an auxiliary archwire. Diode laser was applied to remove the gingiva covering maxillary right lateral incisor to help its eruption. After full repositioning of 3 incisors, 22 was surgically reached, extracted, transplanted in the right position and splinted to adjacent central incisor using composite resin.
3 weeks after, root canal treatment was performed together with the composite splint removal. Fixed appliance was placed on all the incisors as a splint. Light forces were applied and successful alignment was reached in 6 months. Fixed appliance was terminated in 12 months, until maxillary canines erupt naturally. Removable appliance was placed as a retainer.
Results: Patient was recalled every 6 months, was examined clinically and radiographically. There were no symptoms and patient was satisfied during 4-year follow-up. In the end of 4 years, 3D volumetric tomography showed adequate alveolar bone formation around maxillary left lateral incisor and minor resorption around root apex.
Conclusions: Long term follow-up is crucial for trauma cases due to internal or external resorption risk. In our case we present an early treatment of impacted dilacerated tooth in a pediatric patient before further complications occurs after childhood.
Methods:
9 year-old-male patient referred to our Department of Pediatric Dentistry at Marmara University due to disturbed eruption of maxillary incisor teeth as a his main complaint. His dental history revealed a severe fall from bicycle few years ago resulting facial and dental trauma while he had full primary dentition. At the first examination, 11 and 21 were erupted and crown of 21 was positioned towards vestibular side. Both 12 and 22 didn’t erupt yet. Panoramic and periapical radiographs revealed that 12 was below gingiva and maxillary 22 was positioned parallel to horizontal plane. 3D Volumetric Tomography was used in order to see detailed tooth positions. Severe dilaceration and malformation on the root of maxillary left lateral incisor was noticed.
In first step 11 and 21 were repositioned using an auxiliary archwire. Diode laser was applied to remove the gingiva covering maxillary right lateral incisor to help its eruption. After full repositioning of 3 incisors, 22 was surgically reached, extracted, transplanted in the right position and splinted to adjacent central incisor using composite resin.
3 weeks after, root canal treatment was performed together with the composite splint removal. Fixed appliance was placed on all the incisors as a splint. Light forces were applied and successful alignment was reached in 6 months. Fixed appliance was terminated in 12 months, until maxillary canines erupt naturally. Removable appliance was placed as a retainer.
Results: Patient was recalled every 6 months, was examined clinically and radiographically. There were no symptoms and patient was satisfied during 4-year follow-up. In the end of 4 years, 3D volumetric tomography showed adequate alveolar bone formation around maxillary left lateral incisor and minor resorption around root apex.
Conclusions: Long term follow-up is crucial for trauma cases due to internal or external resorption risk. In our case we present an early treatment of impacted dilacerated tooth in a pediatric patient before further complications occurs after childhood.