397 - Advanced Imaging for Diagnosing Traumatic Injuries in the Primary Dentition

Abstract:

Introduction: Traumatic dental injuries are common occurrences in early childhood, often resulting from falls, play-related accidents, or sports activities. Due to the close anatomical relationship between primary teeth and developing permanent successors, injuries to the primary dentition present unique diagnostic and management challenges. Accurate diagnosis is essential, as inaccurate assessment or delayed intervention may lead to complications. Even with proper treatment, unfavorable prognosis includes pulp necrosis, infection, altered eruption patterns, or developmental disturbances in the permanent teeth.

Case Report: This presentation discusses a 6-year-old male who was referred to Connecticut Children’s Medical Center Emergency Department with a chief complaint of progressive facial swelling following dental trauma in the primary dentition. Patient reported four-day history of pain, swelling and tooth mobility. Patient struck his mouth on a wheelbarrow handle three weeks prior. Past medical history is non-contributory. No current medications reported. The patient has an allergy to Amoxicillin. Clinical exam revealed upper lip swelling tracking periorbitally and left buccal swelling at the angle of the mandible. Intraoral exam revealed vestibular swelling adjacent to #F and mobility of #F and #G. An occlusal radiograph taken by the patient’s dental home revealed possible root fracture of #F and parents reported concern for alveolar fracture. CT revealed dehiscence of the maxillary bone along the left maxillary central and lateral primary incisors. This report will detail complications following subluxation of primary incisors and the advantages of advanced imaging in diagnosing traumatic dental injuries.