IADT Dental Trauma Guidelines 2012

Key terminology and definitions regarding the diagnosis, classification, and treatment of traumatic dental injuries based on the 2012 IADT guidelines.

TDI

Traumatic dental injuries, which comprise $5\,\%$ of all injuries in children and young adults.

Infraction

An incomplete fracture (crack) of the enamel without loss of tooth structure.

Enamel Fracture

A complete fracture of the enamel with loss of enamel structure but no visible sign of exposed dentin.

Enamel-Dentin Fracture

A fracture confined to enamel and dentin with loss of tooth structure, but without exposing the pulp.

Enamel-Dentin-Pulp Fracture

A fracture involving enamel and dentin with loss of tooth structure and exposure of the pulp.

Crown-Root Fracture Without Pulp Exposure

A fracture involving enamel, dentin, and cementum with loss of tooth structure, but not exposing the pulp, often extending below the gingival margin.

Root Fracture

A fracture involving the root of the tooth in a horizontal or oblique plane, where the coronal segment may be mobile or displaced.

Alveolar Fracture

A fracture involving the alveolar bone where segment mobility and dislocation of several teeth moving together are common.

Concussion

A luxation injury where the tooth is tender to touch or tapping, has not been displaced, and has no increased mobility.

Subluxation

An injury where the tooth is tender to touch or tapping and has increased mobility but has not been displaced from its socket.

Extrusive Luxation

Partial displacement of the tooth out of its socket, making the tooth appear elongated and excessively mobile.

Lateral Luxation

Displacement of the tooth in a direction other than axial, typically associated with a fracture of the alveolar process and an ankylotic (metallic) sound on percussion.

Intrusive Luxation

Axial displacement of the tooth into the alveolar bone, resulting in immobility and a high, metallic (ankylotic) sound on percussion.

Avulsion

The complete displacement of a tooth out of its dental socket.

PDL

Periodontal Ligament; the vitality of its cells is the primary factor in the prognosis and treatment choice for an avulsed tooth.

Dry Time

The period an avulsed tooth is out of the mouth; if this time is $60$ minutes or more, the PDL cells are considered non-viable.

HBSS

Hanks Balanced Storage Medium; a recommended osmolality balanced medium for transporting an avulsed tooth.

Flexible Splint

A stabilization device used for $2$ to $4$ weeks that allows slight tooth motion to promote periodontal and pulpal healing.

Partial Pulpotomy

The treatment of choice for young patients with pulp exposure to preserve pulp vitality and ensure continuous root development.

Calcium Hydroxide

A suitable material used for pulp capping, partial pulpotomy, or as an intra-canal medication to prevent root resorption.

Chlorhexidine Gluconate

An antibacterial rinse, typically $0.1\,\%$ or $0.12\,\%$ alcohol-free, used for $1$ to $2$ weeks to maintain oral hygiene after trauma.

Ankylosis

Replacement resorption where the root is fused to the bone, often characterized radiographically by a lost periodontal ligament space and clinically by a high-pitched percussion sound.

Decoronation

A procedure that may be necessary in growing patients when an ankylosed tooth shows infraposition of more than $1\,\text{mm}$ to maintain alveolar bone contour.

Pulp Canal Obliteration

The expected outcome in successfully healed open-apex teeth after a luxation injury or replantation.