Management of a Complex Dentoalveolar Traumatic Injury with Multiple Avulsions

BACKGROUND: Dentoalveolar trauma is a major cause of tooth loss in children. Avulsion, luxation, crown, and root fracture are the injuries to primary and permanent dentition. The incidence of trauma for maxillary anterior teeth ranges for 4%-91%. Many case reports have been published regarding the treatment of trauma to anterior teeth; however, case reports comprising multiple avulsions including canines and premolars are rare in literature. METHOD: After mouth rinsing was done with 2% betadine solution, the luxated teeth numbers 31 and 42 were repositioned into the tooth socket and were secured with the composite resin-wire splint. Tooth number 32 was extracted because it was disarticulated from the socket, and the socket was disrupted because of the alveolar fracture. The maxillary avulsed teeth could not be reimplanted because of the alveolar socket damage which was due to the alveolar bone fracture. RESULTS: The patient was reevaluated for the removable prosthesis in recall visits; the patient was well adapted to the appliance with no complaints regarding mastication and speech. The patient was advised to report periodically for further adjustments in the prosthesis and for radiographic evaluation. CONCLUSIONS: This case report includes proper history taking, diagnosis, and treatment of a complex dentoalveolar trauma along with short-term prosthetic rehabilitation for improvement of aesthetics, phonetics, and mastication of growing child.