Greetings and courtesy to you and other colleagues.
In the mentioned case, there are several cases that make it necessary not to do replant, the first case is the long extra oral time (by the way, the suitable solutions for maintaining the loosened teeth are Hanks Balance Salt Solution, cold low-fat milk, normal saline, and saliva). The second thing is that in the case of ankylosing, we did not help the patient, and again, the vertical alveolar defect and its reconstruction will be necessary for us in the future. According to the mentioned cases, not replanting the tooth and imposing an unnecessary cost will be preferable considering the best situation considered for the prognosis of central teeth. In addition, due to the long extra oral time and the absence of a silent carpet, there is a high chance that the mentioned teeth will go to the root resorption replacement process, which completely rules out the treatment.
Well, now that we are not doing treatment, what should we do? Examining the adjacent teeth for the possibility of damage and breaking the alveolar process and vitality tests and follow-up of the teeth, checking the soft tissue of the lips and gums for the possibility of damage and remaining hard tooth tissue in them. Prescribing antibiotics if needed and tetanus vaccine, which, of course, has been injected for the patient according to the time elapsed since the accident and the possibility of the patient going to medical treatment centers based on the diagnosis of the medical treatment staff.
But in the case of avulsed teeth: no fixative treatment is recommended to return at least beauty and function for the above case, because the patient is still at the age of growth, so the use of H-Breech acid or splinting the teeth together is possible due to the remaining three-dimensional growth. It will not be a suitable treatment and it will disrupt the perimaxillary growth pattern. Therefore, mobile treatment with short follow-ups of 3 to 6 months and changes in size and design, clasps, etc. It is recommended in movable prosthesis to prevent growth disorders.
The important point that causes this patient to
The title of a long-term case is not to lose the space of the missing teeth and to maintain the contact of the lateral teeth with the canine and to maintain the jaw arch in the perimaxillary area, which turns this case into a multidisciplinary case and requires orthodontic consultation. There will be a need for ortho treatment to maintain the normal position and prevent loss of proper growth in the perimaxilla.
By doing the above, after approaching the end of the growing age (which will not necessarily be 18 years old and may be earlier than the mentioned time and according to the lateral X-ray and examination of the shape and shape of the neck vertebrae), you can seek permanent treatment that closes He will decide on the condition of the patient. which includes two fixed treatments (bone reconstruction and implant and fixed prosthesis based on implant or crown and bridge) and one mobile treatment (partial denture cast).
There are a lot of small and big hidden things and points about the mentioned case, but this is a summary of the things that seemed to me according to my level of knowledge and experience.
I would be happy if you could inform me of the corrections and errors in the summary made by me.
This post is written by Dr_MahmoodBeheshtifar