International Association of Dental Traumatology: Dental Trauma Guide Flashcards
What are the different luxation injuries that can occur?
- concussion
- subluxation
- extrusion
- lateral luxation
- intrusion
- avulsion
What hard-tissue fracture injuries can occur ?
- enamel infraction
- enamel fracture
- uncomplicated crown fracture
- complicated crown fracture
- uncomplicated crown-root fracture
- complicated crown-root fracture
- root fracture
- alveolar fracture
When should you follow up with a primary patient who has experienced enamel fracture?
no follow up
When should you follow up with a primary patient who has experienced enamel-dentine fracture?
8 week review
When should you follow up with a primary patient who has experienced crown fracture?
- 1 week
- 8 weeks
- 1 year [radiograph if endo treatment carried out]
When should you follow up with a primary patient who has experienced crown/root fracture?
- 1 week
- 8 weeks
- 1 year [radiograph if endo carried out]
When should you follow up with a primary patient who has experienced root fracture?
- 1 week
- 4 weeks [splint removal]
- 8 weeks
- 1 year
When should you follow up with a primary patient who has experienced alveolar fracture?
- 1 week
- 4 weeks [splint removal & take radiograph]
- 8 weeks
- 1 year [radiographs]
What outcomes should you consider when a patient comes for clinical reviews after hard-tissue trauma?
- periodontal healing
- pulp healing
- pain
- discolouration
- tooth loss
- quality of life
- aesthetics
- trauma related dental anxiety
When should you follow up with a primary patient who has experienced concussion?
- 1 week
- 8 weeks
When should you follow up with a primary patient who has experienced subluxation?
- 1 week
- 8 weeks
When should you follow up with a primary patient who has experienced extrusion?
- 1 week
- 8 weeks
- 1 year
When should you follow up with a primary patient who has experienced lateral luxation?
- 1 week
- 4 weeks [splint removal]
- 8 weeks
- 6 months
- 1 year
When should you follow up with a primary patient who has experienced intrusion?
- 1 week
- 8 weeks
- 6 months
- 1 year
When should you follow up with a primary patient who has experienced avulsion?
- 1 week
- 8 weeks
How long should a tooth that has experienced subluxation be splinted? [not always splinted]
2 weeks
How long should a tooth that has experienced extrusion be splinted?
2 weeks
How long should a tooth that has experienced lateral luxation be splinted?
4 weeks
How long should a tooth that has experienced intrusion be splinted?
4 weeks
How long should a tooth that has experienced avulsion be splinted?
2 weeks
How long should a tooth that has experienced root fracture [apical/mid third] be splinted?
4 weeks
How long should a tooth that has experienced root fracture [cervical third] be splinted?
4 months
How long should a tooth that has experienced alveolar fracture be splinted?
4 weeks
What is enamel infraction?
an incomplete fracture (crack or crazing) of the enamel, without loss of tooth structure
What are the clinical findings of an enamel-dentine fracture?
- normal mobility
- positive pulp sensibility test
- not TTP
How should an enamel-dentine fracture be treated?
- re-bond tooth fragment if pt has it [rehydrate in water or saline for 20 mins]
- cover exposed dentine with GIC or composite resin
- if exposed dentine is within 0.5mm of pulp place a COH lining & cover with GIC/comp
What are the clinical findings of an enamel-dentine-pulp fracture?
- normal mobility
- not TTP
- exposed pulp is sensitive to stimuli
- check for luxation or root fracture
How should an enamel-dentine-pulp fracture be treated?
Immature roots & open apices:
- partial pulpotomy or pulp capping with calcium hydroxide
- re-bond tooth fragment or restore with GIC/composite
What are the clinical findings of a crown-root fracture?
- pulp sensibility tests usually positive
- TTP
- coronal fragment is usually present and mobility
What radiographs should be taken for a crown-root fracture?
- one periapical radiograph
- occlusal radiograph
What are the clinical findings of a concussion injury to a tooth?
- normal mobility
- tooth is TTP & touch
- normally responds to pulp sensibility testing
How is concussion of a tooth treated?
no treatment is needed [monitor pulp for a year]
What are the clinical findings of a subluxation injury to a tooth?
- increased mobility but not displaced
- bleeding from gingival crevice
- tender to touch or tapping
- tooth may not initially respond to pulp testing
How is a subluxation injury treated?
- normally no treatment needed
- if there is excessive mobility or tenderness, use passive & flexible splint for 2 weeks
- monitor pulp for 1 year
What are the clinical findings of an extrusion injury?
- tooth appears elongated
- increased mobility
- no response to pulp sensibility tests
What are the radiographic findings of an extrusion injury?
- increased PDL apically & laterally
How should an extrusion injury be treated?
- reposition tooth by pushing it back into tooth socket under LA
- passive & flexible splint 2 weeks
- monitor pulp
- RCT if pulp becomes necrotic
What is lateral luxation?
Displacement of tooth in lateral direction, usually associated with a fracture or compression of the alveolar socket wall
What are the clinical findings of a lateral luxation injury?
- tooth displaced in a palatal/lingual or labial direction
- usually associated fracture of the alveolar bone
- tooth is frequently immobile
- high metallic (ankylotic) sound
- no response to pulp sensibility tests
What are the radiographic findings of an lateral luxation injury?
widened PDL space
How should a lateral luxation injury be treated?
- reposition tooth
- stabilise for 4 weeks with passive & flexible splint
- monitor pulp
- decide if tooth needs RCT or not [based on stage of root development]
What is an intrusive luxation injury?
Displacement of the tooth in an apical direction into the alveolar bone
What are the clinical findings of an intrusion injury?
- tooth displaced axially into alveolar bone
- tooth is immobile
- high metallic (ankylotic) sound
- no response to pulp sensibility tests
What are the radiographic findings of an intrusion injury?
- PDL space may not be visible for some of the root
- cemento-enamel junction is located more apically
How is an intrusion injury [to a tooth with incomplete root formation] treated?
- allow re-eruption without intervention
- if no re-eruption within 4 weeks, initiate orthodontic repositioning
- monitor pulp condition
- decide if RCT is needed
