Acompanhamento por 4 anos de um caso clínico de traumatismo dentofacial

Abstract

This case report aims to describe the clinical and radiographic follow-up, over 4 years, of a case of dentofacial trauma treated at the Faculty of Dentistry of the Federal University of Juiz de Fora (UFJF). The patient attended the Dentistry III clinic in 2018, complaining of crown fractures of his upper central incisors, without pulp exposure, and a cut-blunt lesion on the mucosa of the lower lip communicated with a laceration on the face of the lower lip caused by a faint. The treatment, carried out immediately and in a single session, consisted of indirect pulpal protection of fractured teeth 11 and 21, followed by direct guidance with composite resin and suturing of the lower lip in planes. Over 4 years of radiographic follow-up of this clinical case, a radiolucent region was observed, with permanence of the lamina dura, suggestive of injury resulting from concussion associated with traumatized teeth 11 and 21, after 1 year of restorative and therapeutic intervention. After 4 years of follow-up, this partially diffuse radiolucent appearance had resolved, without any need for endodontic or surgical intervention. Clinically, traumatized teeth always responded positively to thermal tests of pulp vitality, having presented as intercurrences in the last 4 years discoloration and chipping of the surface of composite resin restorations, which were repaired. Therefore, carrying out an immediate conservative intervention, in order to establish a favorable environment for the recovery of the pulp and acquired support tissues, is of paramount importance for a good prognosis of traumatized teeth in young patients. Proservation with radiographic examinations and periodic pulp vitality tests is essential to help in the correct diagnosis of possible post-traumatic complications and minimize the use of unnecessary therapies. Minimally invasive interventions, such as the repair of composite resin restorations, when possible, should be recommended to protect the traumatized tooth.