Introduction
Treatments done in pediatric dentistry not only have an immediate effect on pain felt by the child, but also has long term effects on the functionality, esthetics, and stability of occlusion. Hence, any decision regarding dental treatment in a child, should also take long term consequences into consideration to prevent iatrogenic orthodontic treatments in the future.
Case Report
A 13 year old male child reported to the clinic with a complaint of pain in lower right back region of teeth since 15 days, with bleeding from the same tooth for the past one week.
Patient was completely asymptomatic 15 days back and then he noticed pain in his lower right back region of teeth. Pain was sharp and persistent, which aggravated on taking hot and cold foods, and persisted even after removal of the stimulus. Pain subsided after taking medication.
On extra oral examination, no abnormality was detected in hairline, skin, eyes, nose, ears, lips, nails, lymph nodes and TMJ.
On intra oral examination, a grossly carious lesion was seen in 46. Generalised stains and calculus was seen. The dentition was entirely permanent dentition, with a Class I molar and canine relationship. The overjet was 3 mm and overbite was 4 mm. No abnormality was detected on soft tissue examination.
(This is a case report for space maintenance in a permanent dentition. To read a case report on space maintenance in a primary dentition, you may click here.)
Hard Tissue Examination
- Teeth present- (Permanent dentition)
- 17, 16, 15, 14, 13, 12, 11, 21, 22, 23, 24, 25, 26, 27, 37, 36, 35, 34, 33, 32, 31, 41, 42, 43, 44, 45, 46, 47
- Stains/Calculus - +/++
- Grossly carious IRT 46
- Molar relationship- Angle’s class I
- Canine relationship- class I
- Overjet - 3 mm
- Overbite - 4 mm
Provisional diagnosis was chronic irreversible pulpitis in 46. An intraoral periapical radiograph was taken and the final diagnosis was confirmed to be a chronic alveolar abscess.
Treatment Plan
- Emergency Phase: Not required
- Medical/Systemic Phase: Not required
- Preventive Phase: Oral hygiene instructions given
For the preparatory phase, oral prophylaxis, followed by fluoride application was done. Oral hygiene instructions were given.
For the corrective phase, extraction of 46 followed by prosthetic rehabilitation was planned, with a periodic recall and follow up every 3 months.
- Maintainence Phase: Periodic recall and follow up every 3 months.
Corrective Phase
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