iadt fractures Flashcards
Management of enamel fracture in primary teeth?
Smoothen sharp edges.
Management of enamel fracture (E infraction) in permanent teeth?
If not extensive: Smoothen edge.
If extensive: Etch + seal with bonding resin to prevent bacterial ingress and discoloration.
Management of uncomplicated crown fracture in primary teeth?
GIC or composite restoration.
Management of uncomplicated crown fracture in permanent teeth?
Account for missing fragments (soft tissue radiographs).
Rebond fragment if found (after 20 min saline soak).
If near pulp (within 0.5mm): IPC with CaOH + GIC.
Restore with composite if no tooth fragment found.
Management of complicated crown fracture in primary teeth?
Vital pulp therapy (pulpotomy using Ca Silicate/MTA) + RMGI + CR under LA.
No tx if uncooperative and refer specialist.
Management of complicated crown fracture in permanent teeth?
Partial pulpotomy (Cvek) preferred. [open/closed apex permanent tooth using non staining calcium silicate cement/MTA]
DPC or full pulpotomy as alternative.
If severe # requiring post-retained crown, do RCT if mature tooth/closed apex.
Management of crown-root fracture in primary teeth?
LA + Remove mobile fragment, assess restorability.
Restorable + NO pulp exposed : CR/GIC Resto
Restorable + pulp exposed → pulpotomy/RCT+ Restore
Unrestorable → extract tooth or loose fragments, leave firm ones in situ.
Management of complicated crown-root fracture in permanent teeth (immature)?
Partial pulpotomy.
Future options: 1ortho/2surgical extrusion, 3RCT-if symptomatic, 4root submergence, 5intentional replantation, 6autotransplantation, 7extraction.
Management of complicated crown-root fracture in permanent teeth (mature)?
RCT.
Future options same as immature: 1ortho/2surgical extrusion, 3RCT, 4root submergence, 5intentional replantation, 6autotransplantation, 7extraction.
Management of root fracture in primary teeth?
If not displaced → no treatment.
If displaced but not excessively mobile → allow spontaneous reposition(even with some occl interference).
If severe mobility → extraction + leave firm fragments or reposition + splint 4 weeks.
Management of root fracture in permanent teeth?
LA + Reposition displaced coronal segment + check radiographically.
Flexible splint 4 weeks (up to 4 months if cervical fracture).
Monitor pulp condition over time; do NOT initiate RCT immediately.
Mature teeth where the cervical fracture line is located above the alveolar crest and
coronal fragment is very mobile, removal of the coronal fragment, followed by RCT and a post-retained crown will likely be required.
FUTURE TX OPTIONS:
1) orthodontic extrusion of the apical segment f/by crown lengthening surgery
2) surgical extrusion or
3) RCT if only symptomatic and not because no response to sensibility test; If pulp necrosis develops → treat only coronal fragment (apical segment often heals). //apexification if oblique root fracture
5, 6)-
7) extraction
Management of alveolar fracture in both dentitions?
LA + reposition + flexible splint 4 weeks.
Suture gingival lacerations if present.
No endodontic treatment at emergency visit—monitor pulp over time.
Management of uncomplicated crown-root fracture in permanent teeth?
If mobile fragment → La +stabilize temporarily until treatment plan is finalized. Restoration if restorable
FUTURE TX OPTIONS:
1) Orthodontic extrusion of non-mobile fgmt, f/by
rest.(may need period. re-contouring surgery after extrusion)
2) Surgical extrusion
3)RCT if the pulp- necrotic and infected
4) Root submergence
5) Intentional replantation
6) Autotransplantation
7) Extraction
