Volume 2, issue 2

EDITORIALDear Members,

In the course of conversations with members, it has become apparent that many would appreciate to participate in ses-sions of brainstorming in how to treat dental trauma.

That’s the reason why I fi gured that it would be interesting to present a case and open the discussion in the format of a quiz within our Newsletter.

Indeed, there is such a variety of scenarios in dental traumatology, that decision-making can be challenging, even when trying to follow the IADT guidelines or the soon to be released IADT’s DTG (Dental Trauma Guide).

It has to be emphasized, though, that proper treatment can be provided only if a correct diagnosis of the injury is estab-lished fi rst. Diagnosis lies in an effective, precise and complete anamnesis followed by a thorough clinical and radio-graphic examination. Only then an accurate diagnosis of the totality of the injuries can be made. Additionally, let’s keep in mind that one tooth can be affected by several injuries at the same time. The association of several types of injuries can make it hard to follow treatment recommendations and to decide which is the best treatment option.

To inaugurate some brainstorming within the Newsletter, I chose this clinical case. Even though it is of extremely com-mon occurrence in a dental offi ce, I noticed that “in the real world” quite divergent approaches exist in the management of these types of injuries.

Shall we brainstorm together?

Cecilia Bourguignon- Paris, FranceEditor of the IADT’s Newsletter

cecilia.bourguignon@libertysurf.fr

IADT Newsletter

International Association of Dental Traumatology

Clinical Case - Quiz

A 9 year-old girl, Audrey, hit her left central incisor on the corner of a marble table while playing with her brother at home. There was no injury to her chin or any other part of her face. She arrived at the dental offi ce 2 hours after the injury.

Clinical examination reveals a crown fracture with pulp exposure on the left central incisor. There is no abnormal mobility of this tooth or of the other upper and lower anterior teeth. No lacerations of the gums are present. All upper and lower anterior teeth are responding normally to palpation and percussion. The teeth respond to cold testing and EPT (electric pulp testing), but the left central incisor shows a slightly delayed response. No other signs of trauma are visible, including on the posterior teeth.

Radiographic examination reveals a crown fracture with pulp exposure on the left central incisor and that all upper anterior teeth are immature.

Diagnosis is thus crown fracture with pulp exposure (complicated crown fracture) of the left upper central incisor.Question 1- What is the best treatment option for this immature (open apex) left central incisor?a- Direct pulp cappingb- Partial pulpotomy (Cvek’s pulpotomy)c- Pulpotomyd- Root canal treatment (apexifi cation)e- Pulpal revascularization

Question 2- If the above injured tooth were mature (closed apex) instead of immature, would you change the treatment you recommended in question 1? If yes, which treatment would you choose? a- Direct pulp cappingb- Partial pulpotomyc- Pulpotomyd- Root canal treatment

Question 3- If the injured tooth were a primary tooth and the patient’ age was 4 years old, which treatment would you recommend?a- Direct pulp cappingb- Partial pulpotomyc- Pulpotomyd- Formocresol pulpotomye- Root canal treatment for primary tooth

* The answer to these questions will be given in the next issue of our IADT’s Newsletter. Treatment options and progno-sis will also be discussed. Additionally, this will be available online at the IADT’s website (www.iadt-dentaltrauma.org).

Upcoming events:IADT’s 16th World Congress in Dental Traumatology-

Verona, Italy – June 11–13, 2010. “PROGNOSIS IN DENTAL TRAUMATOLOGY: CURRENT CONCEPTS”.

10th International Congress Turkish Endodontic Society-

Istanbul, Turkey- September 23–25, 2010.

Oceania International Implant Congress-

Sydney, Australia- September 23–26, 2010. “IMPLANTOLOGY: AN INTEGRATED APPROACH”

European Association for Osseointegration (EAO)-

19th Annual Scientifi c Meeting- Glasgow- October 6–9, 2010.

German Society of Endodontology-

Annual Meeting- Munich, Germany- October 21–23, 2010.

Trans-Tasman Endodontic Conference-

Christchurch, New Zealand- November 4–6, 2010.

German Society of Dental, Oral and Craniomandibular Sciences-

Frankfurt/Main, Germany- November 10–13, 2010. “INTERDISCIPLINARY DENTISTRY”

UK “Pan-Dental Society Meeting”-

Liverpool, UK- November 11–12, 2011.

IADT’s 17th World Congress in Dental Traumatology-

Rio de Janeiro, Brazil - 2012.

Please become a member or renew your membership to show your support to the IADT.