PMC4370105_01
Extraoral view showing contusion lesion and abrasion on the chin.
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At extraoral clinical examination, the presence of contusion lesion and abrasion on the chin was observed (Figure 1).
Panoramic radiograph. Normal TMJ structures, without injury.
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TMJ structures, without injury (Figure 2). Thus, extraoral injuries treatment was restricted to the cleaning and disinfection of the damaged soft tissue.
PMC4370105_02
(a) Initial intraoral view. (b) Bone fracture reduction by digital pressure.
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Intraoral examination revealed the presence of lateral luxation towards the lingual surface of mandibular right lateral incisor (without mobility) and alveolar fracture of the area of teeth mandibular right and left central incisor with lingual displacement (Figure 3(a)). The bone fracture reduction was difficult to execute because of its extension (Figure 3(b)).
(a) Flexible splint made with resin composite and 0.7 mm orthodontic wire onto the labial surface of the teeth involved and the immediately adjacent teeth. (b) Radiographic of the injured area.
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Next, a splint made with resin composite (Filtek Z350 XT, 3M ESPE) and 0.7 mm orthodontic wire was placed onto the labial surface of the teeth involved and the immediately adjacent teeth (not injured) (Figure 4(a)). At the periapical radiographic examination of the injured area, the image showed the presence of open axes in the three teeth affected by trauma (Figure 4(b)).
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PMC4370105_04
(a) Clinical aspect after removal of the splint showing the normality of soft tissues. (b) Radiographic image without splint (after 6 weeks of the trauma) indicating no pulp and periodontal pathologies.
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After 6 weeks, the splint was removed and the clinical (Figure 5(a)) and radiographic (Figure 5(b)) findings indicated normality of soft and hard tissues with no pulp and periodontal pathologies.
Six-month radiographic follow-up. Closure process of the apexes of the traumatized teeth continued normally.
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The follow-up radiographic examination evidenced the continuity of the closure process of the apexes of the traumatized teeth (Figure 6).
(a) Five-year clinical follow-up. (b) Radiographic image after 5 years of the trauma. Full closure of the apexes and marked obliteration of the root canal lumens.
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The 5-year follow-up indicated the presence of normal clinical aspects (Figure 7(a)). Roeko cold spray test. Radiographically, the full closure of the apexes followed by a marked obliteration of the root canal lumens could be verified (Figure 7(b)).