1- trauma

2 main types of injuries to dentition

Hard tissue- teeth, alv bone, other facial bones

Soft tissue- gingiva, mucosa, skin, lips, cheeks, palate, tongue

4 classifications of hard tissue injuries

Crown or root fractures

Luxation injuries- to periodontal tissue

Alveolar injuries- to supporting bone

3 types of crown fracture

Enamel infraction

Uncomplicated vs complicated crown fracture — most common type of trauma

Enamel infraction- how to diagnose

Hairline crack in enamel

Trans illumination through crown- can retain stains

No immediate treatment needed- monitor

Uncomplicated crown fracture involves…

Enamel or enamel + dentin

No pulp exposure

Complicated crown fracture involves … treatment?

Enamel + dentin + pulp

Direct pulp exposure

Urgent pulp therapy to preserve vitality

Crown-root fracture vs intra alveolar root fracture

Involves crown and root

Fracture of root encased in bone

How can the fracture divide the root in an intra alveolar fracture?

Horizontal/transverse- line perpendicular to long axis of toot

Oblique- at angle across root- more complex

Types of luxation injuries?

Concussion

Subluxation

Lateral luxation

Intrusion

Extrusive Luxation

Avulsion

Concussion

Tooth traumatised by an impact- doesn’t change from normal position

Subluxation

Impact causes slight mobility, no significant displacement

Pain on percussion

Bleeding from gingival sulcus

Lateral luxation

Displaced in B-L direction, sully with fracture of alv bone

Immobile, locked by bone

Metallic sound on percussion

Intrusion

Apical displacement

Crown appears shorter

Metallic sound on percussion

Immobile

Extrusive luxation

Coronal displacement

Tooth appears elongated

Mobility

Hemorrhage from gingival sulcus due to PDL disruption

4 types of injuries to supporting bone?

Comminution of alv socket

Fractured of B/L alv socket wall

Fracture of alv process with/out involving socket

Fractures of mandible/maxilla with/out involvement of socket

3 types of injury to gingiva or oral mucosa

Laceration of gingiva

Contusion of gingiva

Abrasion of gingiva

Mechanical vs environmental vs human factors causing traumatic dental injury

Sports, transport, roughhousing (aged 2-4), violence

Deprivation, overcrowding

Physical abuse, iatrogenic procedures

Peak incidence and who effected more?

2-4 yrs + 8-10 yrs

2x more in boys

What are the predisposing factors for traumatic dental injuries?

Increased overjet

Protrusion of upper incisors

Insufficient lip closure

What type of injury effects primary vs permanent dentition?

Luxation- max CI most

Uncomplicated crown fracture