330 - Managing Trauma to Permanent Anterior Teeth: A Case Report

Traumatic dental injuries (TDIs) are common in children and adolescents, due to their high levels of physical activity, lack of coordination, and proneness to accidents. Children and adolescents often have immature permanent teeth with open apices, large pulp chambers and immature root formation. While the apex is open in the immature permanent teeth, the teeth are the most resilient to TDIs. However, when a TDI has pulpal effects, this can lead to future tooth necrosis and infection due to immature permanent teeth relying on pulp vitality for continued apexogenesis. When a TDI occurs, in order to enhance the tooth’s long term prognosis, preserve tooth vitality and maintain tooth function, treatment can range from non-surgical root canal treatment to no treatment at all.

This case report presents an 11-year-old boy referred to the University of Minnesota School of Dentistry pediatric clinic following a fall that occurred 24 hours prior. The patient had jumped on a ball and hit the ground face first, fracturing teeth #8 and #9. Patient did not lose consciousness, felt no pain, but reported sensitivity when touching his fractured teeth. #9 had a pinpoint pulp exposure clinically visible. Radiographic findings revealed widened PDL and periapical radiolucency at the apex of #9. Endodontic testing performed 7 days post-injury revealed pulpal and apical injuries on both #8 and #9. This case report details the examination, diagnoses and treatment provided to the patient in order to preserve natural dentition, restore function, and minimize the risk of future complications from the trauma.