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Oro-dental traumas are unpleasant events that affect an increasing number of people each year. They occur mainly in the upper frontal teeth as the result of not serious traffic accidents, after assault with blunt objects, and as it merely affects the female gender, they may also be caused by domestic accidents or fainting because of nutritional deficiency.

What it should be done in case of such an event:

First of all, women should not do certain household chores that would involve intense or hard physical effort requiring climbing on chairs, tables, stairs, etc. when they are alone at home.

In case of dental trauma, it is imperative to call the dentist immediately, regardless the time. From the telephone conversation or after seeing the case, the dentist shall decide on the nature of trauma and whether it can be treated in the dental practice or hospital intervention is required.

For the treatment to be successful, it is advisable that the time elapsed between the accident and the therapeutic intervention should be as short as possible.

If you find yourself in a situation where a tooth has completely fallen out of your mouth, it is forbidden to keep it in water or in the napkin. The tooth shall be placed either in physiological serum or in milk, and in the absence thereof the injured person should keep it in the mouth, in saliva, between the cheek and the lower back teeth, like a candy. These teeth can often be replanted by the dentist. Replanting can be done in MAXIMUM 2 HOURS FROM THE ACCIDENT.

Case presentation:

On a Saturday morning, I’m called by an old friend telling me that his wife has suffered a domestic accident resulting in the upper front teeth trauma. After a brief anamnesis over the phone, I realize the seriousness and complexity of the case and I think it’s best to go directly to the surgery department, at the dentistry faculty, where hopefully she was to be helped by a physician with experience in traumatology. Once arrived there, she was refused treatment on the ground they did not have the equipment and materials for treatment. On hearing this, I made the decision to personally intervene on emergency on the weekend:

Step 1 – 12 hours after trauma: strong anesthesia, manual repositioning of teeth (4 teeth affected in different degrees) in their natural position and their temporary immobilization with stainless steel (Figures 1 and 2)

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Step 2 – 2 days later, check-up and area cleaning

Step 3 – 3 weeks after the trauma, I have replaced the temporary immobilization with a long-term element, made of composite material, much more comfortable for the patient (Figure 3)

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Step 4 – 2 months later: control and hygienization of the affected area (Figure 4)

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Step 5 – 7 months after the trauma, I removed the immobilization and applied the aesthetic fillings on the affected teeth. (Figure 5)

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Currently, the patient is recovered and under observation with control and radiography at every 6 months. The teeth preserved their nerve!

Dr. Florin Popastate

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