492 - Multidisciplinary Management of Unconventional Incisor Intrusion and Severe Bleeding Control

Case Report: This case report discusses a 9 year old male patient who presented to Children’s Wisconsin Emergency Department following a traumatic dental injury, which included severe intrusion of his maxillary permanent central incisors. This report includes short and long-term trauma management as well as management of excessive intra-operative bleeding during surgical repositioning of a tooth. The treatment course deviated from the intended plan, with excessive hemorrhaging upon attempting to surgically reposition an incisor. Reposition was aborted so that the patient was admitted for in-patient assessment of blood loss.  The other intruded incisor was retained without repositioning due to emergent bleeding of the neighboring tooth, with subsequent treatment of orthodontic extrusion, endodontic treatment, and a resin build-up. An interim removable partial denture was fabricated to provide an esthetic replacement for the missing permanent incisor. This case reflects a multifactorial, multidisciplinary approach to clinical decision making for an unconventional dental trauma.

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