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4th yr- CCD2- Trauma Symposium > Luxation and Avulsion Injuries > Flashcards

Luxation and Avulsion Injuries Flashcards

1
Q

Describe a luxation injury

A

An injury that causes damage to the periodontal ligament

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2
Q

List the different classifications fro a luxation injury

A
  1. Concussion
  2. Subluxation
  3. Extrusion
  4. Lateral Luxation
  5. Intrusion
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3
Q

What is a concussion injury

A

Haemorrhage and Oedema in Periodontal Structure

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4
Q

Describe the periodontal ligament fibres in a concussion injury

A

They are intact

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5
Q

Describe how a concussion tooth presents clinically

A
  1. Very tender
  2. Not dispalced
  3. Not mobile
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6
Q

What is a subluxation injury

A

Gingival haemorrhage

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7
Q

Describe the periodontal ligament fibres in a subluxation injury

A

Are torn

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8
Q

Describe how a subluxation tooth presents clinically

A
  1. Mobility

2. No displacement

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9
Q

How do we manage a concussion and subluxation injury

A

Soft diet

possible splint if mobile but not common

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10
Q

What is an extrusion injury

A

Occlusion displacement of tooth along vertical axis

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11
Q

Describe the periodontal ligament fibres in a extrusion injury

A

Rupture of periodontal fibres and Neurovascular bundle

Periodontal ligament torn

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12
Q

Describe how an extrusion injury presents clinically

A
  1. Clinically elongated
  2. mobile
  3. Gingival Haemorrhage
  4. Occlusal Interference
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13
Q

What is a lateral luxation injury

A

Simultaneous rupee and compression of periodontal ligament with fracture to the alveolar socket

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14
Q

Describe how a lateral luxation injuty presents clinically

A
  1. Usually crown is displaced labially
  2. may be mobile
  3. Gingival haemorrhage
  4. May be occlusal interference
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15
Q

How do we treat extrusion of lateral luxation injury

A
  1. Reposition tooth
  2. Physiological Splint for 3-4 weeks
  3. Antibiotics, chlorhexidine
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16
Q

What is an intrusion injury

A

Tooth displaced vertically upwards

17
Q

Describe the PDL in an intrusion injury

A
  1. Extensive Crushing of Periodontal Structures
  2. Disruption of Neurovascular Bundle
  3. Significant number become necrotic
18
Q

How do we manage intrusion injuries

A
  1. Leave it and it may spontaneously erupt
  2. Orthodontically extrude
  3. Surgically extrude
19
Q

What factors do we need to consider before deciding a treatment option for intrusion injuries

A
  1. Open or closed apex
  2. Patients age
  3. Intrusion severity
  4. Eruptive potential
  5. Likelihood to become non vital
20
Q

List the situation in which you would leave an intrusion injury

A
  1. Open apex with less than 7mm intrusion severity

2. Closed apex up to 3mm intrusion severity

21
Q

List the situation in which you would orthodontically reposition an intrusion injury

A
  1. Open apex with more than 7mm intrusion severity

2. Closed apex 3-7mm intrusion severity

22
Q

List the situation in which yo would surgically reposition an intrusion injury

A
  1. Open apex with more than 7mm intrusion severity

2. Closed apex more than 7mm intrusion severity

23
Q

What does the prognosis of an avulsion injury depend on

A
  1. Extra oral time

2. Extra oral storage medium

24
Q

List some extra oral storage medium that can improve prognosis

A
  1. Normal saline

2. Milk

25
Q

When is unfavourable healing guaranteed

A
  1. Extra oral time more than 60 mins in a medium

2. Dry extra oral time more than 30 mins

26
Q

What happens to the PDL when a tooth is avulsed

A

PDL dies

27
Q

What effect does PDL death have on the tooth

A
  1. Bone is now in direct contact with tooth

2. Ankylosis (infra occlusion) and Replacement Resorption

28
Q

What are the disadvantages of not reimplanting

A
  1. Infraocclusion
  2. Gingival contour
  3. Multiple Visits
  4. Tooth will be lost
29
Q

What are the advantages of reimplanting

A
  1. Aesthetics
  2. Space Maintenance
  3. Maintain options (bone preservation, transplants)
  4. Prevent restorative treatment
30
Q

How do we reimplant

A
  1. LA
  2. Irrigate socket
  3. Hold tooth by crown only
  4. Gently reposition
  5. Ask patient to bite on cotton wool roll
  6. Placem flexible splint
31
Q

What is the survival rate of a pulp following avulsion of an open apex

A

30%

4th yr- CCD2- Trauma Symposium (7 decks)

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