History
- 10 yr old girl.
- Tooth 8 was fractured 3 weeks ago in a sporting event.
- Patient was seen by her GP a week after the injury, who restored 8.
- Case was referred to me for consult to evaluate 8 for endo.
Treatment
The tooth tested WNL to pulpal and 
periradicualar testing. so, no endodontic treatment was recommended. I noticed the pustules on her lip and careful history taking revealed the pustules appeared two weeks after the traumatic incident. The broken fragment was also not found after the trauma. I suspected the fragment could have been lodged in the lip and took a radiograph of the lip which showed the fragment. (radiograph attached). Surgery was performed to remove the fragment.
Relevant points
In any trauma case Its important to:
- Examine the facial structure for any splinters or foreign body or tooth fragment lodged
- Look for any fractures elsewhere in the facial skeleton.
- Perform vitality tests on all anterior teeth. You will be surprised to see how many pulps turn non vital in the long run even though there was no sign an injury at the moment of the traumatic incident.
- Reviews to assess vitality.
- Update yur knowledge with the latest guidelines of trauma management. have a copy ready in the treatment rooms.
Cases like these are not very common, but when they happen, its important to diagnose correctly and treat quickly.
