Permanent Trauma: Concussion and Subluxation

Question 1

What is meant by the term concussion?

Answer 1

A tooth which has recieved a blow and is TTP due to oedema and haemorrhage in the PDL.
The tooth supporting structures have been injured but are intact, so there is not increased mobility or displacement of the concussed tooth.
No bleeding from gingival sulcus.

Question 2

What is meant by the term subluxation?

Answer 2

The tooth has not been displaced but has increased mobility, is TTP and loose due to rupture of PDL fibres.
Often bleeding from gingival sulcus.

Question 3

Describe the radiographic finidngs of a tooth with concussion or subluxation.

Answer 3

Often no radiographic abnormalities found.

Question 4

What treatment is recommended following concussion or subluxation?

Answer 4

• Relief of occlusal interferences by selective grinding of opposing teeth
• Soft diet for 2 weeks
• Splinting not usually recommended but, if carried out, only done so for 2 weeks
• 1 and 2 month follow ups

Question 5

What complications may occur?

Answer 5

• Minimal risk of pulp necrosis, particularly in teeth with a narrow apical foramen (more mature)- sensibility testing necessary at initial appointment and follow ups (1 and 2 months)
• Root resorption can occur, but is very rare