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Concept
Dental trauma
Summary
Dental trauma refers to trauma (injury) to the teeth and/or periodontium (gums, periodontal ligament, alveolar bone), and nearby soft tissues such as the lips, tongue, etc. The study of dental trauma is called dental traumatology.
Dental injuries include:
Enamel infraction
Enamel fracture
Enamel-dentine fracture
Enamel-dentine fracture involving pulp exposure
Root fracture of tooth
Concussion (bruising)
Subluxation of the tooth (tooth knocked loose)
Luxation of the tooth (displaced)
Extrusive
Intrusive
Lateral
Avulsion of the tooth (tooth knocked out)
This injury involves the alveolar bone and may extend beyond the alveolus. There are five different types of alveolar fractures:
Communicated fracture of the socket wall
Fracture of the socket wall
Dentoalveolar fracture (segmental)
Fracture of the maxilla : Le Fort fracture, zygomatic fracture, orbital blowout
Fracture of the mandible
Trauma injuries involving the alveolus can be complicated as it does not happen in isolation, very often presents along with other types of tooth tissue injuries.
Signs of dentoalveolar fracture:
Change to occlusion
Multiple teeth moving together as a segment and are normally displaced
Bruising of attached gingivae
Gingivae across the fracture line often lacerated
Investigation: Require more than one radiographic view to identify the fracture line.
Treatment: Reposition displaced teeth under local anaesthetic and stabilise the mobile segment with a splint for 4 weeks, suture any soft tissue lacerations.
Soft tissues injuries are presented commonly in association with dental trauma. Areas normally affected are lips, buccal mucosa, gingivae, frenum and tongue. The most common injuries are lips and gingivae. For lips, important to rule out presence of foreign objects in wounds and lacerations through careful examination. A radiograph can be taken to identify any potential foreign objects.
Gingivae lacerations that are small normally heals spontaneously and do not require any intervention. However, this can be one of the clinical presentation of an alveolar fracture.
Official source
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