Fracture and splint
A two for one special: a fracture and splint!
CC: “I fell while off the trampoline and hit my tooth!”
Dx: #8 class 2 fracture, #9 class 2 mobility
Tx: #8 tooth fragment rebond, splint, flexible splint on #C/7/8/9/10/H, follow up in 7-10 days
🔑: When encountering a trauma with multiple injuries (more intense ones coming up 😉), it can be stressful. But it doesn’t have to be! Break down the problem into different parts and tackle them one at a time. This patient presented with a little anxiety, #8 fracture with tooth fragment in hand, and #9 mobility. So let’s take care of the anxiety first with a little nitrous (or a lot 😂). Then let’s do the exam. Surprise, no pulpal exposure so that’s a plus. Sensitivity is a concern so give a little local anesthesia of your choice (note the tissue blanching in the after picture). Now I use a bur to give a slight facial bevel to #8 tooth and fragment (allowing for greater surface area for bonding and better color transition). Add etch, bond, and flowable composite, and you’re good to go. There are little tricks I use to facilitate this rebonding process and I can go over next time. Now we tackle the splint with fishing line and more etch, bond, and flowable composite. That’s it! What was the most intense traumas have you dealt with before? Let me know below!
Bonus 🔑: Note that the patient has class II malocclusion. Due to the greater overjet and poorer lip competence, our patient was at a greater risk for dental trauma. Another reason seeing your orthodontist is important!
Dosdogru, Elif Yaman, et al. "Maxillary incisor trauma in patients with class II division 1 dental malocclusion: associated factors." Journal of Istanbul University Faculty of Dentistry 51.1 (2017): 34.
#notjustbabyteeth #pedodontics #pediatricdentistry #dentalphoto #orthodontics #oralpathology #oralsurgery #omfs
