Dental Fractures and Injuries Quiz

Crown Infraction

• An incomplete fracture (crack) of the enamel without loss of tooth enamel substance
• The enamel remains attached to the underlying dentin

Complicated Crown Fracture

• A fracture involving enamel and dentin, exposing the pulp

Uncomplicated Crown Root Fracture

• A fracture involving enamel, dentin, and cementum, but not the pulp

Complicated Crown Root Fracture

• A fracture involving enamel, dentin, and cementum, exposing the pulp

Root Fracture

• A fracture involving cementum, dentin, and the pulp

Concussion

• A minor injury to the periodontium with no displacement or mobility of the tooth

Subluxation

• An injury to the periodontium without tooth displacement, but with slight mobility
• Damage to the blood supply of the pulp and periodontium is usually minor, but pulpal problems can occasionally result

Extrusive Luxation

• Tooth displacement in an extrusive direction, involving the periodontal support and pulpal blood supply

Lateral Luxation

• Tooth displacement from its long axis, with the apical end displaced labially and the coronal part palatally. The pulpal blood supply is usually completely severed

Intrusive Luxation

• Tooth displacement apically, leading to crushing of neurovascular bundles entering the pulp and severe damage to the cementum and periodontium

Avulsion

• Complete displacement of the tooth from the alveolus, with disruption of the pulpal blood supply

Follow up Evaluation

• Radiographic evaluation every 6 weeks, 6 months, 12 months, then yearly
• Vitality test
• Mobility assessment
• Percussion

Observation of Color Changes

• Gray crown discoloration indicates necrosis
• Yellow crown discoloration indicates calcification

Pulpal Necrosis

• Studies indicate that approximately 1-16% of traumatized anterior teeth will develop pulpal necrosis

Observation of Soft Tissue Changes

• Swelling, fistula, and sinus formation

Treatment of Crown Infraction (Enamel Infraction)

• Typically requires no treatment unless associated with luxation injury
• Etching and sealing with resin to prevent discoloration if necessary

Enamel Fracture

• Fracture confined to enamel with no exposed dentin
• Usually requires no treatment
• Bonding of tooth fragments, if available
• Grinding/restoration with composite resin if fracture is extensive

Enamel-Dentin Fracture

• Fracture involving enamel and dentin, exposing dentin
• Bonding of tooth fragments, if available
• Provisional treatment with a glass-ionomer or permanent restoration using a bonding agent and composite resin.
• Definitive treatment with accepted dental restorative materials

Uncomplicated Crown Fracture

• Fracture involving the enamel and dentin, but not the pulp.
• No specific treatment needed; closely monitored for complications.

Complicated Crown Fracture

• Fracture involving the enamel, dentin, exposing the pulp.
• Options for treatment: direct pulp capping, pulpotomy, root canal treatment + class IV restoration, root canal treatment + post & core.

Incisal Edge Reattachment

• Used for reattaching fractured tooth fragments
• Adhesive dentistry and composite technology allow for good reattachment.

Reattachment Techniques

• Various techniques and materials have been reported for reattachment of fractured teeth.
• Authors sometimes use a combination of simple reattachment, labial chamfers, and internal grooves combined with bonding.

Crown-Root Fracture (Uncomplicated)

• Fracture involving enamel, dentin, and cementum, but no pulp exposure.
• Emergency treatment is initial temporary stabilization.
• Definitive treatment varies based on tooth maturity, and may involve fragment removal, gingivectomy (sometimes ostectomy), endodontics, and restoration.

Crown-Root Fracture (Complicated)

• Fracture involving the enamel, dentin, and cementum, exposing the pulp.
• Differential treatments depend on clinical findings and tooth maturity (open or closed apex)
• Possible treatments include emergency stabilization, partial pulpotomy, root canal treatment + restoration.

Intrusion

• Tooth displacement into the alveolar bone
• Treatment may include spontaneous eruption, orthodontic repositioning, surgical repositioning

Avulsion

• Complete tooth displacement from the socket
• Treatment includes immediate replantation, preserving the tooth in a suitable medium and promptly seeking dental care.

Subluxation

• An injury to the supporting structures causing tooth mobility
• Typically doesn't require treatment, supportive measures (splinting) are appropriate.

Patient Instructions

• Avoid participation in contact sports
• Soft food for 2 weeks.
• Brussh teeth with soft toothbrush after each meal
• Use chlorhexidine (0.1%) mouth rinse twice a day for 1 week.

Follow-up

• Clinical and radiographic assessment
• Regular follow ups (as per case type)

Test your knowledge on various types of dental fractures and injuries. This quiz covers concepts such as crown fractures, root fractures, and periodontal injuries, emphasizing their definitions and implications. Prepare to assess your understanding of dental trauma terminology and classifications.