Dento-Alveolar Fractures

Question 1

What is a dento-alveolar fracture?

Answer 1

Fracture of alveolar bone which may or may not involve the alveolar socket

Question 2

What are the clinical findings of a dental-alveolar fracture?

Answer 2

Complete alveolar fracture extending from the buccal to the palatal bone in the maxilla and from the buccal to the lingual bony surface in the mandible
Segment mobility and displacement with several teeth moving together
Occlusal disturbance
Gingival laceration

Question 3

What is the treatment for dento-alveolar fracture?

Answer 3

Reposition any displaced segment
Stabilise by splinting
Suture gingival lacerations if present
Monitor the pulp condition of all teeth involved

Question 4

How should a dento-alveolar fracture be followed up?

Answer 4

Monitor clinically and radiographically :
- root development including canal width and length, compare with neighbouring unaffected tooth
- root resorption

Question 5

When should a dento-alveolar fracture be followed up?

Answer 5

4 weeks (including splint removal), 6-8 weeks, 4 months, 6 months and 1 year
Then annually for at least 5 years

Question 6

Why is it important to follow up a dento-alveolar fracture?

Answer 6

Risk of pulpal necrosis if closed apex is 50% at 5 years

Question 7

What advice should be given after a dento-alveolar fracture?

Answer 7

Soft diet for 7 days
Avoid contact sport whilst splint in place
Careful OH with use of chlorhexidine gluconate mouthwash 0.12%