Teeth Trauma Classification and Diagnosis

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Questions and Answers

Which of the following is NOT a classification of tooth injuries?

Dental hygiene (correct)

Dental luxation

Dental concussion

Dental avulsion

What is concussion?

Injury of the tooth support structures without increased tooth mobility or tooth displacement.

What is luxation?

Tooth loosens without total avulsion and moves out of its normal position.

What is avulsion?

Complete displacement of a tooth from its socket in the alveolar bone. Signup and view all the answers

Give clinical signs of mild trauma in concussion.

Hyperemia in PDL vessels without affecting pulp. Signup and view all the answers

Give clinical signs of severe trauma in concussion.

Hyperemia involves PDL vessels + pulp, leading to necrosis and devitalization. Signup and view all the answers

What are general clinical signs of luxation?

Pain is more severe immediately after the injury, gradually decreases, and chewing is difficult. Signup and view all the answers

What are clinical signs of lateral luxation?

Very painful, impaired occlusion, and laceration with bleeding of the mucosa. Signup and view all the answers

What are clinical signs of intruded luxation?

The tooth is stationary and below the level of the adjacent teeth. Signup and view all the answers

What are clinical signs of extruded luxation?

The tooth is loose and looks longer than usual. Signup and view all the answers

What are clinical signs of avulsion?

Lip and cheek injuries, empty tooth socket, bleeding or blood clot. Signup and view all the answers

How is concussion diagnosed?

Clinical presentation only, no radiographic signs. Signup and view all the answers

How is lateral luxation diagnosed?

The root is shorter, PDL space is enlarged. Signup and view all the answers

How is extrusive luxation diagnosed?

Apical part of the tooth socket is empty, PDL space around the root is enlarged. Signup and view all the answers

How is intrusive luxation diagnosed?

Tooth is intruded in the socket, root is much higher than adjacent teeth. Signup and view all the answers

How is avulsion diagnosed?

Tooth socket is completely empty. Signup and view all the answers

How are primary teeth treated in concussion?

The opposing tooth should be reduced. Signup and view all the answers

How are permanent teeth treated in concussion?

Rest by liquid + semi-liquid diet, temp dressings, mouthwashes, and endodontics if vital. Signup and view all the answers

What is the general treatment for luxation?

The tooth should be repositioned and fixed. Signup and view all the answers

What kind of splints are used for fixation in luxation?

Vestibular arch splint, Hirschfield's interrupted ligature wire splint, Atanasov's continuous ligature wire splint, 8-shaped ligature wire splint. Signup and view all the answers

Study Notes

Tooth Injury Classification

Dental Concussion: Injury to supporting structures without increased mobility or displacement.
Dental Luxation: Tooth loosens without total avulsion; includes lateral, extrusion, and intrusion types.
Dental Avulsion: Complete displacement of a tooth from its socket.
Tooth Fractures:
- Crown Fractures: Vary from enamel-only to involvement of dentin with pulp exposure.
- Root Fractures: Classifications include cervical third, middle third, and apical third.
Combined Injuries: Involvement of teeth and jaw bones.

Concussion

Definition: Injury to tooth support structures with no mobility or displacement; potential for post-operative pain and exposure.
Clinical Signs (Mild Trauma): Hyperemia in the periodontal ligament (PDL) vessels, reversible condition.
Clinical Signs (Severe Trauma): Progression to pulp necrosis, color change in the crown from pink to brownish/bluish, and signs of devitalization.

Luxation

Definition: Tooth loosens and moves out of its normal position; adjacent tissues may be ruptured.
Clinical Signs: Severe pain initially that decreases, difficulty in chewing; mobility depends on type and alveolar bone condition.
Types of Luxation:
- Lateral Luxation: Severely painful with impaired occlusion and mucosal laceration.
- Intruded Luxation: Tooth appears stationary and positioned below adjacent teeth.
- Extruded Luxation: Tooth appears loose and elongated.

Avulsion

Clinical Signs: Often accompanied by lip and cheek injuries; tooth socket may be empty or contain a blood clot; tooth may also be positioned transversely to alveolar ridge.

Diagnosis Methods

Concussion: Based on clinical presentation; no radiographic signs.
Luxation Diagnosis:
- Lateral Luxation: Shortened root, enlarged PDL space.
- Extrusive Luxation: Empty apical part of the socket, enlarged PDL.
- Intrusive Luxation: Tooth intruded into socket, root higher than adjacent teeth.
Avulsion Diagnosis: Confirmation of an empty tooth socket.

Treatment Approaches

Concussion Treatment:
- Primary Teeth: Opposing tooth reduction for rest.
- Permanent Teeth: Liquid diet, temporary dressings, mouthwashes for quicker resorption, and endodontic treatment for non-vital teeth.
Luxation Treatment:
- Repositioning and fixation of tooth with splints for 8-12 weeks, under local anesthesia if needed.
- Types of Splints:
  - Vestibular arch splint (composite resin)
  - Hirschfield's interrupted ligature wire splint
  - Atanasov's continuous ligature wire splint
  - 8-shaped ligature wire splint.

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Description

This quiz covers the classification of tooth injuries, including dental concussion, luxation, and avulsion, along with various types of tooth fractures. Additionally, it explores clinical signs, methods of diagnosis, differential diagnosis, and treatment options. Perfect for dental students and professionals looking to enhance their knowledge in dental trauma.