title: Orthodontic management of traumatic avulsion of permanent incisors in a child with sickle cell anaemia: a case report.
abstract: BACKGROUND
  Avulsion of permanent teeth in children resulting from trauma is an acute emergency presentation. When not adequately managed, it may result in functional and aesthetic disturbances, with implications for more complicated and prolonged treatment which require planning and biocompatibility in terms of forces used in moving the teeth orthodontically. Literature is scarce on a reported case of this nature and this is the first report in the literature in Nigeria.
  
  
  METHODS
  We report on a case of avulsion of both maxillary central incisors in an 8-year-old male child of Sub-Saharan African ethnicity with sickle cell anaemia. One of the incisors produced by the parents was replanted at the clinic. The replanted tooth was later traumatized during the course of treatment which resulted in mobility and subsequent extraction of the tooth. At a later presentation at the clinic, orthodontic therapy was instituted. While orthodontic therapy has been considered to be completely noninvasive, special precautions should be taken in the clinical management of sickle cell anaemia patients to prevent local vaso-occlusive events.
  
  
  CONCLUSIONS
  The sequeale of traumatic avulsion in a medically compromised patient with sickle cell anaemia is presented. Prompt and early presentation for dental management is very important; while prevention and management of dental trauma should be recognized as a public health issue. Dental trauma in sickle cell anaemia can be minimized by practicing preventive measures with the use of mouth guard which is an effective device for preventing dental injuries, and patients should be advised to wear them during activities to prevent dental injuries.
authors.affiliation: Orthodontic Unit, Department of Child Dental Health, College of Medicine, University of Lagos, Lagos, Nigeria. yemisanu@yahoo.com
authors.forename: Sanu O
authors.initials: SO
authors.lastname: Oluwatosin
authors.forename: Oredugba A
authors.initials: OA
authors.lastname: Folakemi
authors.forename: Temiye O
authors.initials: TO
authors.lastname: Edamisan