A Life-threatening Sequel of Usually Innocuous Subluxation Dental Trauma to Primary Tooth: A Rare Complication

Abstract

Background: Primary teeth with subluxation injury carry a low risk of pulp necrosis and are usually overlooked not only by laymen but also by dentists. However, if not monitored or if diagnosis of pulp necrosis in luxated teeth is missed, it may lead to severe and rare complications such as cellulitis or systemic inflammatory response. This presentation aimed to report the first case of odontogenic infection spreading to the contralateral side with a systemic inflammatory response due to maxillary primary tooth subluxation injury. Case description: A 5-year-old male child with bilateral facial swelling, fever, headache, and chills despite parenteral administration of analgesics and antibiotics was referred by the pediatrician. Clinically, there was diffuse swelling of periorbital regions, no involvement of the cranial nerves, and a discolored maxillary right primary central incisor with associated vestibular abscess. A provisional diagnosis of pulpal infection spreading to the contralateral side with a systemic inflammatory response was made. It was decided to extract the necrotic primary tooth due to the general condition of the child, resulting in complete resolution in 5 days. Conclusion: The simple tooth injuries such as luxation of the primary tooth should not be overlooked and should be monitored regularly. An early diagnosis of facial infections of odontogenic origin by the primary care pediatrician is important as the danger zone infection has the possibility of turning into a life-threatening condition via cavernous sinus involvement.

Keywords

• case report
• cavernous sinus involvement
• life-threatening complication
• primary tooth dental trauma
• subluxation injury
• systematic complications