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This case report outlines the unusual presentation of a maxillary alveolar fracture in a 12-year-old child. It is common to see bruising of the attached gingivae and sulcal area, along with a step deformity, mobile fragment and sometimes luxation injuries. In this case, we saw no intra-oral bruising, no obvious luxation injury and the dento-alveolar fragment was not mobile. After the initial treatment, the upper left central and lateral incisors maintained vitality. This case report aims to raise awareness for recognizing less obvious clinical features in alveolar bone fractures, thus improving outcomes for traumatic injuries in child patients.
CPD/Clinical Relevance: To recognize atypical clinical features of a maxillary fracture after a delayed presentation in a paediatric patient.
Article
The risk of a child sustaining a facial fracture increases with age, with 5–15% of all facial fractures occurring in children, mainly boys.1,2 The most common cause of a facial fracture is a motor vehicle accident, but violence accounts for 4% to 61% of fractures.1,3,4,5 The diagnosis of facial fractures in children is more difficult and is under-reported.6 Isolated facial fractures are noted to be less commonly seen, with maxillary fractures occurring less in the child population.1 It is more common for children to present with fractures to the anterior maxillary segment, than the mandible.2 Dento-alveolar fractures are ‘dental injuries that involve a fracture to the supporting alveolar bone’.7
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