Management of luxation injuries Flashcards
How should a concussion injury be managed?
No treatment required but should be monitored for at least one year at one month, two months and then a year.
What are the clinical findings related to a concussion injury?
Tooth tender to touch or tapping.
No displacement or mobility.
Sensibility tests give positive results.
What are the clinical findings for a subluxation injjury?
Tooth is tender to touch and percussion and is mobile. No displacement.
Bleeding from the gingival crevice may be observed.
May respond negatively to sensibility testing indicating transient pulpal damage.
What treatment is indicated for a subluxation injury?
Normally no treatment necessary. HOwever, a flexible splint can be used for patient comfort ffor 2 weeks.
Recall and monitor at 2 weeks, 1 month, 2 months, 6 months and then at 1 year.
What are the clinical findings assoiated with an extrusive luxation injury of a permanent tooth?
Tooth appears elongated and is excessively mobile.
Sensibility tests most likely give a negative result.
Radiographically there is normally ann increased periodontal space apically.
How should an extrusive luxation of a permanent tooth be managed?
Reposition tooth by gently re-inserting into the socket.
Stabilise the tooth for 2 weeks using a flexible splint.
If the tooth is mature and pulpal necrosis is anticipated, root canal treatment is indicated. Also, if signs and symptoms indicate pulpal necrosis. (false negative up to 3 months)
Recall at 2 weeks, 1 month, 2 monthhs, 6months and then one year and once a year for 5 years.
What are the clinical signs of a lateral luxation?
The tooth is normally displaced in a palatal/lingual or labial direction.
Its normally immobile and percussion usually gives a high, metallic sound.
Fracture of the alveolar process present.
Sensibility tests normally give negative results.
What are the radiographical presentations of a lateral luxation injury?
Widened periodontal ligament spaces best seen on occlusal exposures.
What is the treatment for a lateral luxation injury?
Reposition the tooth digitally or with forceps to disengage it from its bony lock and gently reposition into its original location.
Stabilise using a flexible splint for 4 weeks.
Monitor the pulpal condition (false negative possible up to 3 months). RCT indicated if pulp becomes necrotic.
Recall 2 weeks, 1 month, 2 months, 6 months, 1 year and then yearly for 5 years.
What are the clinical signs for an intrusive luxation injury?
Tooth displaces axially into the alveolar bone.
Immobile and percussion usually gives a high, metallic sound.
Sensibility tests usually give a negative result
What are the raidiographical signs of an intrusive luxation?
The periodontal space may be absent from all or part of the root.
CEJ located more apically compared to adjacent teeth sometimes up to the marginal bone level.
How should a tooth with incomplete root formation with a intrusive luxation injury be treated?
Allow eruption without intervention
Orthodontic repositioning if no movement within a few weeks.
If intruded more than 7mm, reposition sugically or orthodontically.
How should a tooth with complete root formation be managed in the event of a intrusive luxation injury?
If tooth intruded less than 3mm, allow spontaneous eruption without intervention. If no movement within 2-4 weeks, reposition surgilcally or orthodontically before ankylosis can occur.
If intruded more than 7mm, reposition surgically. The pulp will become necrotic hecnce initiate root canal treatment 2-3 weeks after surgery and place CaOH. Once repositioned, position with flexible splint 4-8 weeks.
Follow up: as usual…
