Management and Long-term Follow-up of a Case in a Child with Traumatically Avulsed Maxillary Incisor Accompanied by Mesiodens

Abstract

Dental trauma in childhood requires emergency treatment that might range from a simple repositioning, through replantation, to root as well as pulp treatment and apexification depending on severity of the injury. The trauma may be complicated with the existence of supernumerary teeth, and orthodontic treatment other than the management of trauma may be needed either for complication of the traumatized teeth or already existed occlusion problems. We report the management and long-term follow-up of a rare case in a child with traumatically avulsed maxillary incisor accompanied by mesiodens. The patient had a severe trauma to the face, which resulted in avulsion of the maxillary central incisor. Immediate replantation within 30 min after the trauma was performed. Radiographic examination also showed the mesiodens. Since external resorption started during follow-up, and electric pulp testing indicated negative response, we performed root treatment and apexification by calcium hydroxide. The mesiodens was extracted after the stabilization of the patient, followed by orthodontic treatment for the maxillary protraction. Although ankylosis occurred in long-term follow-up, no discomfort in the daily life with good prognosis was noticed.