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Year : 2017  |  Volume : 17  |  Issue : 2  |  Page : 115-117

Maxillary anterior region contact sport trauma in a patient having history of proclined maxillary anterior teeth

1 Department of Oral and Maxillofacial Surgery, College of Dentistry, Jazan, Saudi Arabia
2 Department of Prosthodontics, College of Dentistry, Jazan, Saudi Arabia

Date of Web Publication6-Jun-2017

Correspondence Address:
Fareedi Mukram Ali
Department of Oral and Maxillofacial Surgery, College of Dentistry, Jazan
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-6308.207571

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Trauma to the maxillary central incisors is the most common of all dental injuries. Here we are presenting a case of trauma to the maxillary anterior region while playing football. The patient had dentoalveolar fracture and extrusion of the upper central incisors out of their sockets. The upper central incisors of this patient prior to the trauma were proclined and with inadequate lip coverage. In this report we are highlighting the significance of teeth proclination and lip coverage in the predisposition to injury. Proclined anterior teeth with inadequate lip coverage have to be corrected by orthodontic treatment, especially in individuals involved in contact sports.

Keywords: Dental trauma, proclined anterior teeth, sports injuries

How to cite this article:
Ali FM, Khan MM, Faqihi AA, Mutawwam FA. Maxillary anterior region contact sport trauma in a patient having history of proclined maxillary anterior teeth. Saudi J Sports Med 2017;17:115-7

How to cite this URL:
Ali FM, Khan MM, Faqihi AA, Mutawwam FA. Maxillary anterior region contact sport trauma in a patient having history of proclined maxillary anterior teeth. Saudi J Sports Med [serial online] 2017 [cited 2023 Sep 29];17:115-7. Available from: https://www.sjosm.org/text.asp?2017/17/2/115/207571

  Introduction Top

One-fifth of the total trauma among children is oral trauma and sports trauma is the most common cause in children and young adults as the child enters school and engages in athletic sports activities.[1],[2] The incidence is peaking at 42% for those aged 15–24. Injuries sustained during athletic sports account for 23% of all traumas, heading second to motor vehicle injuries.[3] Most common dental injuries are those involving one tooth and majority of the affected teeth are the maxillary central incisors.[4]

  Case Report Top

A 20-year-old patient came with a complaint of trauma to maxillary anterior region of jaw 24 h before while playing football [Figure 1] and [Figure 2]. On examination, it was found that the patient had dentoalveolar fracture and had extruded both upper central incisors out of its socket [Figure 3].
Figure 1: Intraoral picture of the patient after trauma showing the fractured anterior bone fragment and extrusion of both upper central incisors

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Figure 2: Closer view of the intraoral picture after trauma

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Figure 3: Intraoral periapical radiograph of the patient showing extrusion of the both maxillary central incisor teeth from the bony socket

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Electric pulp test was done to check the vitality of the pulp. However, the pulp was not responding. Thus, after endodontic opinion, no endodontic treatment was initiated at this stage as the pulp may respond in later stages. The patient was kept on observation and called for follow-up after 15 days. Under local anesthetic, teeth were placed back to their sockets. The anterior fractured fragment was stabilized and Erich arch bar with wire fixation done.

We asked the patient for his face picture before trauma, the patient had maxillary anterior teeth proclination and inadequate lip closure.

  Discussion Top

The chances of the permanent incisors trauma increase with increased proclination. Thus, the proclination of the anterior teeth is important in predicting the likelihood of getting a tooth fractured.[1],[2],[4],[5],[6] A Study by Shetty et al.,[4] Rai and Munshi et al.,[7] Patel and Sujan,[8] Ghose et al.,[9] and Hegde and Sajnani [10] had shown that chances of tooth fracture occur more frequently among patients with proclined anterior teeth.

Furthermore, the inadequate lip coverage of the maxillary anterior teeth was found to be significant risk factors.[4],[5],[8],[11] The predictive value of increased proclined teeth may be explained by inadequate lip coverage and it is suggested that the protective effect of lip closure, in addition to adequate occlusal contact area of maxillary and mandibular teeth in normal occlusion, tends to decrease the impacting force of trauma.[11]

The resulting complications of the trauma to the anterior teeth can be costly and time-consuming and many teeth are subsequently lost.[12] Thus, the preventive measures such as orthodontic treatment to correct predisposing risk factors should be directed to protect the risk population to a considerable extent.[2],[8]

  Conclusion Top

The reason for the anterior teeth trauma in the present case report was proclinated teeth and inadequate lip coverage, before trauma. Therefore, the most common reason for the anterior teeth trauma is the proclined teeth with inadequate lip coverage, which can be corrected by the orthodontic treatment, especially in persons involved in the contact sports, who have more chances of trauma while playing sports.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Chaturvedi R, Kumar A, Rana V, Aggarwal A, Chandra L. A correlation of permanent anterior tooth fracture with type of occlusion and craniofacial morphology. Int J Clin Pediatr Dent 2013;6:80-4.  Back to cited text no. 1
Leung SF. Traumatic dental injuries to the permanent dentition. Hong Kong Med Diary Dent Bull 2006;11:15-8.  Back to cited text no. 2
Exadaktylos AK, Eggensperger NM, Eggli S, Smolka KM, Zimmermann H, Iizuka T. Sports related maxillofacial injuries: The first maxillofacial trauma database in Switzerland. Br J Sports Med 2004;38:750-3.  Back to cited text no. 3
Shetty J, Hegde MN, Devadiga D, Yelapure M. Prevalence of anterior tooth fracture due to trauma in southwest coastal population of India – An epidemiological study. Indian J Appl Res 2016;6:316-8.  Back to cited text no. 4
Bhardwaj VK, Fotedar S, Sharma KR, Luthra RP, Jhingta P, Sharma D, et al. Prevalence of anterior teeth fracture among institutionalized visually impaired individuals in Himachal Pradesh, India – A cross-sectional study. J Cranio Max Dis 2015;4:117-22.  Back to cited text no. 5
  [Full text]  
Fleisher GR, Ludwig S. Textbook of Pediatric Emergency Medicine. 6th ed. Philadelphia: Wolters Kluwer; 2010. p. 1291.  Back to cited text no. 6
Rai SB, Munshi AK. Traumatic injuries to the anterior teeth among South Kanara school children – A prevalence study. J Indian Soc Pedod Prev Dent 1998;16:44-51.  Back to cited text no. 7
Patel MC, Sujan SG. The prevalence of traumatic dental injuries to permanent anterior teeth and its relation with predisposing risk factors among 8-13 years school children of Vadodara city: An epidemiological study. J Indian Soc Pedod Prev Dent 2012;30:151-7.  Back to cited text no. 8
  [Full text]  
Ghose LJ, Baghdady VS, Enke H. Relation of traumatized permanent anterior teeth to occlusion and lip condition. Community Dent Oral Epidemiol 1980;8:381-4.  Back to cited text no. 9
Hegde MN, Sajnani AR. Prevalence of permanent anterior tooth fracture due to trauma in South Indian population. Eur J Gen Dent 2015;4:87-91.  Back to cited text no. 10
  [Full text]  
Burden DJ. An investigation of the association between overjet size, lip coverage, and traumatic injury to maxillary incisors. Eur J Orthod 1995;17:513-7.  Back to cited text no. 11
Ali FM, Bhushan P, Saujanya KP, Patil S, Sahane D. Dental trauma: Athletes, coaches, and school teachers must know – A brief review. Saudi J Sports Med 2013;13:7-9.  Back to cited text no. 12
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  [Figure 1], [Figure 2], [Figure 3]


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