Combination of dentoalveolar trumatic injury: a case report         (7- year follow-up)

Traumatic dental injuries present difficult challenges for patients and dentists .As with most types of dental treatment, the primary goal when treating a case is to save teeth at risk of being lost, and restore them to full function and normal appearance. In many cases, the difference between saving and losing a tooth depends on taking the proper action in the immediate aftermath of an injury.

A case of multiple concomitant dental trauma is reported. In 2010, a Saudi male patient, 15 years old, visited the dental office an hour after dental trauma caused by accidentally hit a door of glass  . He complained of  discomfort and bleeding around mobile upper anterior teeth; in the clinical assessment,  tooth #11 had uncomplicated  crown fracture and both #11 and #21 showed partial displacement from their sockets with grade 3 mobility; in the radiographic analysis, they showed an increase in periodontal ligament spaces, a diagnosis of extrusive luxation. The adjacent teeth #12 and #22  presented subgingival bleeding with grade 1 mobility , and were diagnosed with subluxation. After treatment planing, the clinical approach consisted of manual reduction of #11 and #21 and flexible splint of the affected teeth. After 15 days, the splint was removed and teeth#12#11#21 and#22 showed negative pulpal sensibility, maintaining the same results for 4 months. In the 4th month, all affected teeth was diagnosed with pulp necrosis, thus requiring endodontic treatment. After 7 years, the teeth and the surrounding tissue were clinically and radiographically asymptomatic and in function . In conclusion, it is impossible to completely prevent accidents that might result in dental injuries, but their associated complications can be avoided by ready and adequate treatment and follow-up.