Tooth displacement and root dilaceration after trauma to primary predecessor: an evaluation by computed tomography

Abstract

This case report illustrates the relationship between trauma to a deciduous tooth and the consequences to the permanent dentition. The patient suffered an injury to the central incisors at the age of four with resultant pulpal necrosis. The permanent dentition was affected by displacement from its original position and a severe dilaceration at the crown/root junction.

Effects of traumatic dental injuries to primary teeth on permanent teeth - a clinical follow-up study

“…Cone-beam computed tomography (CBCT) has come into use recently and made a major contribution to the diagnosis and treatment planning of traumatic injuries (35). CBCT produces three-dimensional images without enlargement or superimposition of anatomical structures, which facilitates the diagnosis and avoids inappropriate treatment that may increase the chances of damage to primary teeth and their permanent successors.…”

Untitled

“…Sequelae for permanent dentition after a trauma to primary dentition are usually related to intrusive injuries [4][5][6][7][8][9]. The impact by a force in an axial direction often results in displacement of the tooth within the socket [2].…”

“…Intrusive injury to primary dentition often results in anomalous development of the permanent teeth [4][5][6][7][8][9], with a frequency of between 18 and 69% [5][6][7][8]. Many sequelaes can be found in the coronal region, such as structural alterations associated with enamel hypoplasia, crown dilaceration and white, yellow/brown discoloration [4][5][6][7][8][9][10], such was observed in the present clinical case. Developmental disturbances of permanent teeth involving the crown have been reported to occur more frequently than those involving the roots or eruption patterns [10].…”

“…Probably the trauma promoted ameloblasts destruction in the active enamel epithelium [8], crown dilacerations and enamel hypoplasia. Studies evaluated the effect of luxation injuries to primary teeth on the successor permanent teeth in children assisted at emergency centers and observed that hypoplasia was the disturbance most detected through radiographic analysis [4][5][6][7][8][9][10][11]. Depending on the degree of severity of these anomalies, various protocols of treatment may be performed, including whitening, microabrasion, aesthetic conservative restorations and prosthetic rehabilitation.…”

“…The type and severity of traumatic injuries are related to predisposing factors, such as child's age, proximity of primary teeth and permanent germ, stage of root formation or resorption of primary teeth, permanent teeth root formation, root inclination of primary teeth when trauma occurred, treatment conduct and deciduous tooth repair, among others [1][2][3][4][5][6][7]. Primary tooth intrusion may result in a variety of pathologic alterations to permanent teeth, including hypoplasia, crown dilaceration, root angulation or dilaceration, partial or complete arrest of root formation, sequestration of the permanent tooth germ, and disturbances in eruption.…”