Avulsão com reimplante tardio do dente 21 em uma criança de 11 anos: Relato de caso

Abstract

The upper central incisors are the teeth most affected by trauma due to their position in the dental arch. Tooth avulsion is the most serious dentoalveolar injury, characterized by the total displacement of the tooth element out of the socket. Immediate de ntal reimplantation is the best approach in these cases, as it aims to guarantee the viability of the periodontal ligament and alveolar bone. Some factors such as extra alveolar residence time and storage medium are crucial aspects for a good prognosis in the treatment of avulsed teeth. The objective of this work is to describe a clinical case of late reimplantation, in which there was avulsion of tooth 21, and to discuss the clinical management and prognosis of the case. An 11 year old female patient atten ded the (Neptrauma) at the Federal University of Ceará Campus Sobral, 08 days after the trauma, presenting with an avulsion of tooth 21 due to a fall. from the height suffered at school. The tooth was kept in refrigerated milk for 8 days until the interv ention took place. A clinical examination was carried out and the treatment alternative was extra alveolar endodontics, followed by alveolar preparation and reimplantation, using a 0.7mm orthodontic wire as containment. After 15 days, the containment was r emoved and the patient had a favorable prognosis, with follow up being suggested every 3 months. However, the patient only returned after 4 years. Upon performing a new clinical examination, the presence of root resorption was observed. We opted for extrac tion and decoronation, to use the crown as a temporary prosthesis, mainly due to aesthetics, until it was possible to create an implant or removable prosthesis. Therefore, it is concluded that a favorable prognosis in cases of reimplantation after tooth av ulsion is multifactorial and extends from initial care at the time of trauma, such as extra alveolar time and preservation of the tooth in appropriate solutions, to clinical care, which are directly related to the correct monitoring and cooperation of the patient.