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Membership information 1800 444 542
Dentolegal advice 1800 444 542

Avulsion and horizontal root fracture

23 May 2017
By Dr John McNamara

Elly was an active 8-year-old girl; while she and a friend were cartwheeling on Christmas day, she was struck in the mouth by the other girl’s foot. Elly’s upper-right central incisor was avulsed, and the upper left central incisor was palatally luxated (with mid-root horizontal root fracture). Elly’s father placed the avulsed tooth into milk immediately and went directly to her dentist. The dentist replaced the avulsed 11 into its socket and attempted to reposition the 21, but the procedure was unsuccessful. Four days later, Elly presented for assessment.

Fig 1

FIG1

Fig 2

FIG2

The colour of both teeth was good, however neither responded to cold sensibility testing. This presents the following clinical considerations:

  1. What would you do next:
    1. Remove splint and reposition orthodontically?
    2. Leave the tooth as is and observe for vitality sensibility changes
    3. How would you assess changes in vitality/sensibility?
  2. What would determine whether or not you would intervene with active treatment?
  3. What other injuries are likely to be present?
Dr John McNamara will be speaking at our Young Dentist Conference+ in Sydney on 19 August 2017.

Check the IADT Dental Trauma Guide for more information, and come prepared to answer these questions.

Book your place now

These case studies are based on real events and provided here as guidance. They do not constitute legal advice but are published to help members better understand how they might deal with certain situations. This is just one of the many benefits Dental Protection members enjoy as part of their subscription. 
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