256 - Interdisciplinary Management of Dental Trauma in the Mixed Dentition Patient

Abstract:
Traumatic dental injuries in children often require immediate intervention, with an eye toward long-term planning. This case report describes the management of a 9-year-old male who presented following a fall at school, resulting in avulsion of a maxillary incisor and uncomplicated enamel-dentin fracture of his maxillary right central incisor. Reimplantation was not pursued, as clinical and radiographic examination revealed the avulsed tooth to be an erupted supernumerary that was causing eruption disturbance for underlying teeth. The supernumerary tooth resulted in distal ectopic eruption of the permanent maxillary left central incisor and impeded eruption of the adjacent lateral incisor. Acute management included indirect pulp capping and interim restoration of the fractured incisor. The ongoing treatment plan involves interdisciplinary coordination with orthodontics and oral surgery to orthodontically align the central incisor and facilitate exposure and guided eruption of the impacted lateral incisor. This case highlights the importance of comprehensive assessment, with specific consideration of unerupted teeth, when forming a management plan in pediatric dental trauma. Comprehensive dental trauma assessment in the mixed dentition must include evaluation of teeth pending eruption in the involved field, with specific attention to the presence of supernumerary or congenitally absent teeth and/or other eruption abnormalities that might impact reimplantation, stabilization, or other procedure planning.

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