title: Severe fracture of the maxillary alveolar process associated with extrusive luxation and tooth avulsion: a case report.
abstract: OBJECTIVE
  The aim of this report is to present a case of severe fracture of the maxillary anterior alveolar process with substantial bone dislodgement associated with extrusive tooth luxation and avulsion.
  
  
  BACKGROUND
  Dentoalveolar trauma is a challenge to dentistry, especially in young patients, for it can lead to early tooth loss which compromises oral function, esthetics, self-esteem, and alter the long-term plan of care for the victim.
  
  
  METHODS
  A 12-year-old girl with severe dentoalveolar trauma to the maxillary anterior region presented for emergency care for her injury. Treatment consisted of fracture reduction of the alveolar process, repositioning of the teeth that had suffered extrusive luxation, placement of a semi-rigid splint, and suturing of soft tissue lacerations. The traumatized teeth presented with pulpal necrosis and were treated endodontically. After 24 months of follow up, the fracture of the alveolar process was completely healed and the displaced teeth presented no signs of ankylosis or root resorption.
  
  
  CONCLUSIONS
  First-aid care contributed remarkably to this case allowing the re-establishment of esthetics, function, and patient's self-esteem. In spite of trauma extension the treatment outcomes were favorable.
  
  
  CONCLUSIONS
  Cases of dentoalveolar trauma should be evaluated on an individual basis. However, early emergency management and adequate follow-up can prevent further complications and contribute to treatment success.
authors.affiliation: Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Araçatuba, SP, Brazil. celiatomiko@foa.unesp.br
authors.forename: Celia
authors.initials: C
authors.lastname: Saito
authors.forename: Jessica
authors.initials: J
authors.lastname: Gulinelli
authors.forename: Leandro
authors.initials: L
authors.lastname: Cardoso
authors.forename: Idelmo Rangel
authors.initials: IR
authors.lastname: Garcia
authors.forename: Sonia
authors.initials: S
authors.lastname: Panzarini
authors.forename: Wilson
authors.initials: W
authors.lastname: Poi
authors.forename: Celso
authors.initials: C
authors.lastname: Sonoda
mesh_terms: D000539:Alveolar Process / Q000293:injuries*; D001642:Bicycling / Q000293:injuries; D002648:Child; D003790:Dental Pulp Necrosis / Q000209:etiology; D003832:Denture, Partial, Removable; D005260:Female; D005592:Fracture Fixation; D006801:Humans; D007180:Incisor / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000150:complications* / Q000628:therapy; D012390:Root Canal Therapy; D013165:Splints; D014084:Tooth Avulsion / Q000209:etiology*