Alveolar fracture

A jaw-dropping case!

CC: “My son fell and pushed his bottom teeth out!”

Dx: alveolar fracture of mandibular segment of #N, O, P, and Q

Tx: monitor

🔑: This is a case of a 4-year-old boy who sustained an alveolar fracture involving the mandibular segment of teeth #N, O, P, and Q. Clinical evaluation occurred 6 hours after the trauma when adequate hemostasis was achieved. However, the segment was malpositioned facially, leading to an anterior underbite. Radiographs showed no involvement with the permanent successors.

At this point, it is crucial to discuss treatment options with the patient's parents. In this case, two options were presented: monitoring for healing or treatment under general anesthesia to curettage the site of injury and attempt to reposition the segment. After considering the options, the parents chose monitoring.

A two-week follow-up evaluation showed some spontaneous repositioning of the segment, which returned the patient back to a more normal overjet relationship with no anterior crossbite. This outcome highlights the potential for natural healing and remodeling of the bone following an alveolar fracture, especially in young patients.

However, it is important to note that in cases where the alveolar segment remains malpositioned or mobile, surgical intervention may be necessary to achieve optimal healing and prevent long-term complications. As pediatric dentists, it is our responsibility to carefully evaluate each case and discuss all available treatment options with the patient's parents to ensure the best possible outcome for our young patients.

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