Multidisciplinary management of craniodentofacial trauma in children: A case report

Craniofacial trauma in children from bicycle falls can cause simultaneous mild head injury and permanent tooth avulsion, requiring coordinated neurological and dental evaluation, since delays of only minutes in treating avulsion can worsen long-term tooth prognosis. 
Objective: To report multidisciplinary management of mild head injury with complex dentofacial trauma at the emergency department of Kanjuruhan Regional General Hospital. 
Methods: A descriptive single-case report based on history taking, physical examination, head CT scan, and documentation of medical and dental interventions performed in April 2026. 
Results: An 11-year-old boy presented with GCS E4V5M6 after falling from a bicycle, with avulsion of teeth 21 and 22, a crown fracture of tooth 11 with irreversible pulpitis, and multiple craniofacial and extremity abrasions. Head CT showed no intracranial hemorrhage or skull fracture. Replantation of tooth 21 was contraindicated due to root fracture; a direct fiber-reinforced composite bridge was fabricated for tooth 22 using the avulsed crown as a biological pontic, alongside partial pulpotomy of tooth 11. Medical management included parenteral analgesics, antifibrinolytics, and fluid resuscitation, with good short-term neurological and dental outcomes. 
Conclusion: Early coordination between emergency physicians and dentists is essential for preserving young permanent teeth and safely managing mild head injury in children. 
Recommendation: Tertiary care facilities should develop integrated protocols for dentofacial trauma management in pediatric head injury patients to enable a more structured and timely multidisciplinary response.