Permanent Trauma: Fractures of the alveolus

Question 1

How can an alveolar fracture be differentiated from a luxation?

Answer 1

Luaxtion: partial alveolar fracture e.g. of labial or lingual bone plate

Alveolar fracture: complete fracture encompassing the entire alveolar process

Question 2

Where are alveolar fractures most commonly seen?

Answer 2

The mandibular incisor region due to the delicate bone structure in this area.
Fracture usually involves 2 or more teeth and generally follows the PDL of an involved tooth in its vertical course.

Question 3

What is an important feature to consider in the diagnosis of an alveolus fracture?

Answer 3

• Multiple radiographs using varying vertical angulations required
• May look very similair to a root fracture, important to consider differential diagnoses

Question 4

What clinical signs often indicate an alveolar fracture?

Answer 4

• When mobility testing one tooth, several teeth may move
• Haematoma in the adjacent attached gingiva or mucosa

Question 5

What is the current treatment guidance for an alveolar process fracture?

Answer 5

Repositioning and splinting for 4 weeks.

Question 6

What issues can arise in treating an alveolar fracture?

Answer 6

Repositioning can be challenging, root apices are often locked into the buccal aspect of the bone and thus, must be further displaced incisally before the tooth and bone segment can be repositioned.

Question 7

What is the predictor for pulp necrosis in cases of an alveolar fracture?

Answer 7

Late repositioning of fracture = more likely pulp necrosis

Question 8

What other possible complication is there following alveolar fracture?

Answer 8

Root resorption (uncommon)

Question 8

What other possible complication is there following alveolar fracture?

Answer 8

Root resorption (uncommon)