undergrad student Tufts University Boston, Massachusetts, United States
A 16-year-old male patient presented a rare view of a crown of his # 9. In his dental history an avulsion of #9 occurred two years earlier and replanted after 30 minutes. At the time of replantation both central incisors had been endodontically treated. Two years after the first trauma a second trauma occurred. In clinical examination crown of #9 was absent, whereas # 8 showed grade 3 mobility. No tenderness in palpation or percussion was present. In radiographic examination there was no visible root of #9. However, the previous obturation of the canal (gutta-percha) was present. A large lateral lesion was present around the right# 8 with a low-quality obturation of its canal. Radiograph findings showed ankylosis of # 9. After clinical and radiographic examination the anterior maxillary teeth were splinted by a semi-rigid splint. The gutta-percha in the right central incisor was completely removed and multiple areas of perforation were observed. Calcium hydroxide paste was then inserted and was changed four times in six months. After removing CaOH the apical area of the canal was obturated by lateral condensation technique with GP and AH26 sealer, whereas the remainder of the canal was sealed by MTA and, finally, post-operative radiograph was taken. Eight months after splint removal no symptom was present. Also, healing of the lateral lesion was obvious in the follow up radiograph.
Conclusion: Even in severe traumatic cases healing may be seen in follow-ups. However, a precise treatment plan may be an important need.
