Wednesday, March 24, 2010
This 8 year old boy was scared to see me after falling on his face on the way home from school. Believe me, I'm often just as scared of these little patients as they are of me.
Intra-oral x-ray shows intrusion of both central incisors (note discrepancy in position of central incisor edge to lateral incisor edge). Apices seem 90 to 100% formed so repositioning, splinting with composite and SS wire, Ca-OH pulpotomies, and eventually RCT was our planned treatment (96% of teeth with intrusion injuries will become necrotic). Note tooth #9 seemingly with its apex pushed into the nasal space. No root fracture is seen.
You can see the aftermath of the accident. There should be as you know be two teeth nicely with their natural crowns exposed. You can see both teeth intruded well into the gingival tissue. Diagnosis of intrusion greater than 6 mm indicates surgical repositioning.
After a lot of tears, some screaming, and a very unhappy little boy the teeth were repositioned and splinted. Next up the pulpotomies in a few weeks. I hope we become friends by then.