Historically airguns were powerful weapons. Modern models, though less lethal, are still capable of inflicting serious or life threatening injuries. Current United Kingdom legislation fails to take into the account the capacity for airguns to maim and kill. We believe that airguns should be governed by the same law that applies to firearms. We present a case of a potentially fatal airgun injury to the neck. The airgun pellet caused a defect in the anterior wall of the external carotid artery, which required rapid access and surgical repair. We discuss the mechanism of airgun injury and review the literature in terms of investigation and management.
Coronectomy is a widely-accepted technique available for the treatment of impacted wisdom teeth. The fundamental principle is to prevent trauma to the inferior dental nerve (IDN). Many publications have demonstrated its positive outcomes but there is no literature available regarding coronectomy of deciduous teeth. This case report highlights the complex approach to managing a severely infraoccluded 85 in the mixed dentition of a 10-year-old female. The report demonstrates and discusses the combined orthodontic and oral surgical approach to prevent damage to the IDN and to allow space for orthodontic movement. This case demonstrates how nerve sparing techniques in the mixed dentition are achievable.Clinical relevance statement When managing severely infraoccluded and impacted deciduous second molars, clinicians must be aware that the option of a coronectomy should be considered and may be the difference between sparing the nerve or causing permanent injury.Objective The reader should understand that coronectomy is a suitable treatment option in managing impacted deciduous teeth.
Introduction Maxillary incisors have a significant role on the facial aesthetics of an individual. Following trauma to the primary dentition, the maxillary incisors are vulnerable to eruption failure and occasionally root dilaceration. These teeth can be challenging to treat. Discussion This case report demonstrates the complex management of a 10-year-old male who presented with severely displaced and unerupted maxillary central incisors, following a history of dental trauma when he was 4 years old. Cone beam computed tomography revealed the upper maxillary central incisors to be lying transversely across the maxillary arch with the crowns directed superiorly and significantly close to the floor of the nose. The incisal edges of both crowns perforated the labial cortex of the maxilla. The roots of the maxillary central incisors were dilacerated with the apices directed superiorly. A multi-disciplinary approach was taken, with involvement from both maxillofacial surgery and orthodontic teams. Maxillofacial surgeons completed the surgical removal of the ectopic maxillary central incisors, rather than the more common approach of surgical exposure and orthodontic repositioning. In this case, full alignment of these teeth would most likely have led to perforation of the labial cortical plate of bone. Conclusions Although surgery was complex and technique sensitive, both teeth were successfully removed under general anaesthesia with no iatrogenic damage. The patient underwent fixed orthodontics to align the maxillary lateral incisors as central incisors. A multidisciplinary approach along with careful surgical planning and effective communication with the patient and his mother helped to achieve a satisfactory outcome.
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