Interdisciplinary Sequential Management of Combination Traumatic Dental Injuries

Authors

1 Division of Orthodontics and Dentofacial Deformities, Dr Z.A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India

2 Division of Pedodontics and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India

3 Department of Orthodontics and Dentofacial Orthopedics, Dr Z.A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India

4 Department of Oral and Maxillofacial Surgery, Dr Z.A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India

10.4103/atr.atr_96_18

Abstract

Combination dental trauma or combination traumatic dental injuries (C‑TDIs) are often seen with unique presentations. Although most guidelines address the evidence‑based management of such injuries in detail, a sequential protocol and classifications for C‑TDI are lacking. In these scenarios, clinical details with imaging tools play an essential role by helping the clinician apply the elements of the TDI protocol in the correct sequence. However, most cases of C‑TDI are attended by a general dentist, who often finds it difficult to make such clinical decisions, adversely affecting the prognosis. This article reports a case of a 14‑year‑old male patient with avulsion of 12, intrusion of 11, 21, and 13, and uncomplicated crown fracture of 11, 21, and 14, with a sequential interdisciplinary approach for the management and long‑term follow‑up of 10 years.

Keywords


1. Lam R. Epidemiology and outcomes of traumatic dental injuries: A review of the literature. Aust Dent J 2016;61 Suppl 1:4‑20.
2. Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F, et al. International association of dental traumatology. Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth. Dent Traumatol 2007;23:66‑71.
3. Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F, et al. International association of dental traumatology. Guidelines for the management of traumatic dental injuries. II. Avulsion of permanent teeth. Dent Traumatol 2007;23:130‑6.
4. Diangelis AJ, Andreasen JO, Ebeleseder KA, Kenny DJ, Trope M, Sigurdsson A, et al. International association of dental traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol 2012;28:2‑12.
5. Djemal S, Singh P. Smartphones and dental trauma: The current availability of apps for managing traumatic dental injuries. Dent Traumatol 2016;32:52‑7.
6. Andreasen JO, Bakland LK, Andreasen FM. Traumatic intrusion of permanent teeth. Part 2. A clinical study of the effect of preinjury and injury factors, such as sex, age, stage of root development, tooth location, and extent of injury including number of intruded teeth on 140 intruded permanent teeth. Dent Traumatol 2006;22:90‑8.
7. Owtad P, Shastry S, Papademetriou M, Park JH. Management guidelines for traumatically injured teeth during orthodontic treatment. J Clin Pediatr Dent 2015;39:292‑6.
8. MouleA, Cohenca N. Emergency assessment and treatment planning for traumatic dental injuries. Aust Dent J 2016;61 Suppl 1:21‑38.
9. Chaushu S, Shapira J, Heling I, Becker A. Emergency orthodontic treatment after the traumatic intrusive luxation of maxillary incisors. Am J Orthod Dentofacial Orthop 2004;126:162‑72.
10. Elbay ÜŞ, Baysal A, Elbay M, Sarıdağ S. Multidisciplinary approach to delayed treatment of traumatic teeth injuries involving extrusive luxation, avulsion and crown fracture. Oper Dent 2014;39:566‑71.