TOOTH AVULSION

Question 1

Information Given: 10-year-old boy A set of E/O and I/O Clinical photos showing incompetent lips and Class II Div. 2?? Further Information: The patient had episode of avulsion of permanent upper central incisor 2 months ago. He visited a dental clinic and had the tooth replanted.

a. The avulsed upper permanent incisor was with closed apex and the patient visited the dentist after 2 hours of avulsion. What will be the dental management? (5)

Answer 1

 Remove dead PDL tissue with gauze  Soaked with 2% NaF solution for 20 mins (to slow down osseous replacement of tooth)  RCT of avlused tooth can be carried out extraorally or after replantation  Administer LA, irrigate the socket with saline  Examine the alveolar socket, reposition the socket wall if there’s fracture  Replant the tooth slowly with slight digital pressure  Suture gingival laceration if present  Verify normal position of the replanted tooth clinically and radiographically  Flexible splinting for 4 weeks  Administer systemic antibiotics, analgesic  Check tetanus protection, boost injection is needed if no vaccination  Give patient instructions (soft diet, good OHI, use CHX twice a day, avoid contact sports)

Question 2

Information Given: 10-year-old boy A set of E/O and I/O Clinical photos showing incompetent lips and Class II Div. 2?? Further Information: The patient had episode of avulsion of permanent upper central incisor 2 months ago. He visited a dental clinic and had the tooth replanted.

b. List 2 periodontal complications of avulsed tooth. What are the clinical and radiographic findings of the complications? (6)

Answer 2

Question 3

Information Given: 10-year-old boy A set of E/O and I/O Clinical photos showing incompetent lips and Class II Div. 2?? Further Information: The patient had episode of avulsion of permanent upper central incisor 2 months ago. He visited a dental clinic and had the tooth replanted.

c. How can one minimize the complication you mentioned in 6.at the time of avulsion? (4)