Developmental Arrest Of Permanent Germs Secondary To Deciduous Avulsion

This case presents the adverse impact of primary dental avulsion injuries on the permanent dentition and how the functional and esthetics were restored. The upper left deciduous anterior teeth of 6-year-old male patient had exfoliated, and the permanent successors had not yet erupted. The dental history indicated that the left maxillary deciduous central incisor was avulsed at the age of 18 months. X-rays showed the development of the teeth germs of the left maxillary central incisor, lateral incisor and canine were seriously delayed compared to the counterparts. No involvement of the permanent tooth germs is observed for the upper left second premolar and first permanent molar. A low-density area is noted in the crown of the upper left second primary molar, accompanied by root resorption. One year and four months later, it was showed that the germs of the upper left central incisor, lateral incisor and canine had a tendency to decrease in size. At the age of eight, the developmental arrest of the upper left central incisor, lateral incisor and canine was noticed. A removable partial denture with an anatomical occlusal splint was used. So its was supported that there is a higher risk of sequelae to the permanent successor of primary dental avulsion injuries younger than two years old. Regular clinical monitors are needed to prevent cystic transformation of necrotic tooth germs. More attention should be given to the developmental arrest of permanent germs secondary to deciduous avulsion before age of two.