Dentoalveolar Trauma 7 Flashcards
What are the types of injuries to the supporting bone?
Communition of alveolar socket
Fracture of alveolar socket wall
Fracture of the alveolar process
Fracture of the jaw (Mandible/maxilla)
What is communition of the alveolar socket? What injuries is it commonly seen?
Crushing and compression of the socket.
ALWAYS found with intrusion and lateral luxation
What injuries do we commonly see fracture of the alveolar socket wall?
Always found with lateral luxation
Can be found in avulsion and intrusion injuries.
What common sign shows a fracture of the alveolar process?
Socket radiolucency appears without any visible root fracture.
May or may not involve the tooth socket
What is a fracture of the jaw associated with?
Fracture involves the base of the jaw, may also involve the alveolar process, and may or may not involve the tooth socket
How is supporting bone damage managed?
Reposition the bone fragments. Teeth movement can allow bone repositioning to be easier.
Rigid fixation: 6 weeks in adults and 4 weeks in children.
Check radiographically
Consider AB therapy if there are other concurrent injuries such as avulsion.
Treat the inflammation at the fracture line
Follow up for minimum 1 year but ideally annually for 5 years and then every 3 - 4 years.
How is inflammation of the fracture line treated?
AB therapy
If caused by tooth or infected pulp then endo treatment/extraction.
How does time of repositioning the alveolar bone affect the survival of the pulp after injury?
<1 hour = close to 70% survival rate
1 - 24 hours = close to 20% survival rate
> 24 hours = about 5% survival rate.
How well does PDL heal after alveolar fracture?
Often (~75%) heals well.
What is the prognosis like for teeth involved in alveolar fractures?
Prognosis is generally good
How can trauma to developing teeth affect the underlying teeth?
Potential damage to the tooth if the root moves into the developing crown.
Avulsions usually wont do much damage. DO NOT REPLANT.
Lateral luxations are often safe as the force often rotates the crown palatally and so the root moves labially not touching the developing root.
Intrusion often towards the labial in most situations due to the bend of the root labially.
How does age of the injury affect the probability of malformed permanent dentition?
Chance of malformation is highest from 0 - 2 and decreases until about 5 - 6 years of age. (from 70% chance to ~30% chance)
How can oral injuries be prevented?
Mouthguards: Custom made
Faceguards
What are the functions of a mouthguard?
Holds soft tissues of lips and cheeks away from the teeth to help prevent lacerations and bruising.
Cushions and distributes forces.
Prevents violent contact between teeth in opposite arches.
Provides mandible with resilient but braced support
Condyle can reduce concussion, cerebral haemorrhage
Protection against neck injuries.
Fills spaces and supports adjacent teeth so partial dentures can be removed.
Which people benefit from bi-maxillary mouthguard?
Boxers
Recent mandibular fracture (until healed)
Recent concussion
Ortho patients undergoing FFA
High grades of competitive contact sports
