Luxation Injuries Flashcards
What is concussion
Injury to the PDL- no displacement or loosening
Clinical signs of concussion:
No mobility
May be TTP
Positive vitality test
Radiograph normal
Treatment for concussion:
No treatment required
Monitor pulp for one year
Follow up for concussion:
4 weeks
One year
What is subluxation?
Injury to PDL
no displacement
Looseness
Clinical signs of subluxation
Mobility
TTP
negative pulp vitality test
Radiographically normal
Treatment for subluxation:
No treatment usually required
If severe ttp or mobility then can place a splint for two weeks
Monitor pulp for one year
Follow up for subluxation
2 weeks- take splint off
3 months
6 months
Year
Follow up for subluxation
2 weeks- take splint off
3 months
6 months
Year
What is extrusion
Injury to PDL
Incomplete displacement incisally out of socket
Clinical signs of extrusion:
Tooth appears elongated
TTP
Mobile
Negative pulp test
On radiograph:
Increased PDL space
Tooth not seated in socket
Treatment for extrusion:
Give LA and reposition digitally
Place a flexible splint for 2 weeks- 4 weeks if alveolar fracture
If sever extrusion then treated the same as lateral luxation
Monitor pulp- if any signs of pulpal necrosis or inflammatory resorption then do RCT within 2 weeks
Immature- apexification
Mature- CAOH and antibiotics for 6 weeks
Follow up for extrusion
2 weeks
4 wks
8 weeks
6 months
1 year
Annually up to five years
What is lateral luxation
Injury to PDL
Lateral displacement of tooth
Signs of lateral luxation:
Immobile
Locked in bone
Ankylosis sound on percussion
Negative vitality test
May have bone fracture
Radiograph : increased/ widened pdl space
Treatment for lateral luxation:
LA
reposition digitally
Flexible splint for 4 weeks
SS wire and composite labially
Monitor pulp: do RCT in 2 wks if indicated
Immature:
• spontaneous pulp
revascularization
poss
• if pulp nec/inflam
resorp – RCT asap follow immature procedure (apexification/ pulp space revascularization)
Mature:
• pulp necrosis
likely – RCT – CaOH 1m/ CORT- AB 6w to prevent ext inflam resorp
Follow up for lateral luxation
2 weeks
4 weeks
8 weeks
3 m
6m,
1y,
Yearly at least 5y
Intrusion:
Injury to pdl
Displacement apically into alveolar bone
Clinical signs of intrusion:
Immob
• Percussion –
ankylotic sound
• PST -ve
• Lost of PDL space all/part
(esp apically
Treatment for intrusion:
If immature tooth:
Wait for spontaneous eruption 4 weeks
If none- orthodontic repositioning
What radiographs for pdl injuries
PA and occlusal radiograph
