Traumatic Injuries to Primary Dentition

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TRAUMATIC INJURIES TO PRIMARY DENTITION

A. VICTOR SAMUEL III MDS DEPARTMENT OF PEDODONTICS

Contents Introduction Etiology Epidemiology Classification Examination & Diagnosis Treatment Sequlae of injuries to primary dentition Conclusion References

INTRODUCTION Most injuries : 1- 3 yrs of age Learning to walk, run, climb & play adventurously Thinner & more elastic alveolar bone displaced. Close proximity of two dentition Infection developing subsequent to injury poses threat. Vertical position

Graham Roberts, Peter Longhurst. Oral and Dental Trauma in children and Adolescents. 1st ed. United States: Oxford University Press;1996.

ETIOLOGY Iatrogenic newborns injuries in Automobile injuries Assaults Torture Mental Retardation Epilepsy Drug-related injuries Dentinogenesis imperfecta

Falls in infancy Child physical abuse Falls and collisions Bicycle injuries Sports Horseback riding

Andreasen JO, Andreasen FM. Classification, Etiology and Epidemiology. In: Andreasen JO, Andreasen FM. Text Book and Color Atlas of Traumatic Injuries to the Teeth. 3rd edn. Denmark: Mosby, 1994: Chapter 3 . Graham Roberts, Peter Longhurst. Oral and Dental Trauma in children and Adolescents. 1st ed. United States: Oxford University Press;1996.

EPIDEMIOLOGY

The prevalence of traumatic injuries in the 0 to 6 year segment varies from11 to 30%.

Cunha RF, Pugliesi DM, MelloVieira AE. Oral trauma in Brazilian patients aged 0-3 years. Dent Traumatol 2001;17:210-12. Hargreaves JA, Cleaton-Jones PE, Roberts GJ,Williams S, Matejka JM. Trauma to primary teeth of South African pre-school children. Endod Dent Traumatol 1999;15:73-6. Bijella MF,Yared FN, BijellaVT, Lopes ES. Occurrence of primary incisor traumatism in Brazilian children: a house by-house survey. ASDC J Dent Child 1990;57:424-7. Forsberg CM, Tedestam G. Traumatic injuries to teeth in Swedish children living in an urban area. Swed Dent J 1990;14:115-22. YagotKH, Nazhat NY,Kuder SA.Traumatic dental injuries in nursery schoolchildren from Baghdad. Iraq Community Dent Oral Epidemiol1988;16:292-3.

EPIDEMIOLOGY

When the child starts walking alone, between18 and 30months, the risk of trauma increases with incidence twice as high as the average incidence for all children .

Llarena del Rosario ME, Acosta AV, Garcia-Godoy F. Traumatic injuries to primary teeth in Mexico City children. Endod Dent Traumatol 1992;8:213-4. Fried I, Erickson P. Anterior tooth trauma in the primary dentition. Incidence, classification, treatment methods, and sequelae: a reviewof the literature. ASDCJ Dent Child 1995;62:256-61. Nelson LP, Shusterman S. Emergency management of oral trauma in children. Curr Opin Pediatr 1997;9:242-5. YamAA,Diop F, FayeM,Tamba-Ba A, Ba I. Complications of injuries to the deciduous teeth. Clinical and radiographic evaluation: perspectives on management and prevention (apropos 4 cases). OdontostomatolTrop 2000;23:5-9. Glendor U. On dental trauma in children and adolescents. Incidence, risk, treatment, time and costs. Swed Dent J Suppl 2000;140:152.

EPIDEMIOLOGY

At this age, the home is the place where most trauma occurs in males and females as a result of falls.

MestrinhoHD, Bezerra AC, CarvalhoJC.Traumatic dental injuries in Brazilian pre-school children. Braz Dent J 1998;9:101-4. Garcia-Godoy F, Garcia-Godoy F, Garcia-Godoy FM. Primary teeth traumatic injuries at a private pediatric dental center. Endod Dent Traumatol 1987;3:126-9. Bastone EB, FreerTJ,McNamaraJR. Epidemiology of dental trauma: a review of the literature. Aust Dent J 2000;45:2-9. Fried I, Erickson P, Schwartz S, Keenan K. Subluxation injuries of maxillary primary anterior teeth: epidemiology and prognosis of 207 traumatized teeth. Pediatr Dent 1996;18:145-51. Soporowski NJ, Allred EN, Needleman HL. Luxation injuries of primary anterior teeth its prognosis and related correlates. Pediatr Dent 1994;16:96-101.

Summary

CLASSIFICATION

CLASSIFICATIONInjuries to the Hard Dental Tissues and the Pulp Enamel Infraction (N 502.50) Incomplete fracture of the enamel without loss of tooth.

Enamel Fracture (Uncomplicated Crown Fracture) (N 502.50) Fracture with loss of tooth substance confined to the enamel

Andreasen JO, Andreasen FM. Classification, Etiology and Epidemiology. In: Andreasen JO, Andreasen FM. Text Book and Color Atlas of Traumatic Injuries to the Teeth. 3rd edn. Denmark: Mosby, 1994: Chapter 3 .

CLASSIFICATIONInjuries to the Hard Dental Tissues and the Pulp Enamel-Dentin Fracture Fracture) (N 502.51) (Uncomplicated Crown

Fracture with loss of tooth substance confined to enamel and dentin, but not involving the pulp.

Complicated Crown Fracture(N 502.52) Fracture involving enamel and dentin, and exposing the pulp.

Andreasen JO, Andreasen FM. Classification, Etiology and Epidemiology. In: Andreasen JO, Andreasen FM. Text Book and Color Atlas of Traumatic Injuries to the Teeth. 3rd edn. Denmark: Mosby, 1994: Chapter 3 .

CLASSIFICATIONInjuries to the Hard Dental Tissues and the Pulp Uncomplicated Crown-Root Fracture(N 502.54) Fracture involving enamel, dentin and cementum, but not exposing the pulp.

Complicated Crown-Root Fracture(N 502.54) Fracture involving enamel, dentin and cementum, but exposing the pulp.

Andreasen JO, Andreasen FM. Classification, Etiology and Epidemiology. In: Andreasen JO, Andreasen FM. Text Book and Color Atlas of Traumatic Injuries to the Teeth. 3rd edn. Denmark: Mosby, 1994: Chapter 3 .

CLASSIFICATIONInjuries to the Hard Dental Tissues and the Pulp Root Fracture(N 502.53) Fracture involving dentin and cementum, and the pulp.

Andreasen JO, Andreasen FM. Classification, Etiology and Epidemiology. In: Andreasen JO, Andreasen FM. Text Book and Color Atlas of Traumatic Injuries to the Teeth. 3rd edn. Denmark: Mosby, 1994: Chapter 3 .

CLASSIFICATIONInjuries to the Periodontal Tissues Concussion (N503.20) Injury to the tooth-supporting structures without abnormal loosening or displacement of the tooth, but with marked reaction to percussion Subluxation (Loosening) (N 503.20) Injury to the tooth-supporting structures with abnormal loosening, but without displacement of tooth

Andreasen JO, Andreasen FM. Classification, Etiology and Epidemiology. In: Andreasen JO, Andreasen FM. Text Book and Color Atlas of Traumatic Injuries to the Teeth. 3rd edn. Denmark: Mosby, 1994: Chapter 3 .

CLASSIFICATIONInjuries to the Periodontal Tissues Extrusive Luxation (Peripheral dislocation, Partial avulsion) (N503.20) Partial displacement of the tooth out of its socket. Lateral Luxation (N 503.20) Displacement of tooth in a direction other than axially. This is accompanied by comminution or fracture of the alveolar socket.

Andreasen JO, Andreasen FM. Classification, Etiology and Epidemiology. In: Andreasen JO, Andreasen FM. Text Book and Color Atlas of Traumatic Injuries to the Teeth. 3rd edn. Denmark: Mosby, 1994: Chapter 3 .

CLASSIFICATIONInjuries to the Periodontal Tissues Intrusive Luxation (Central Dislocation) (N503.20) Displacement of the tooth into the alveolar bone. This injury is accompanied by comminution or fracture of the alveolar socket. Avulsion (N 503.22) Complete displacement of tooth out of its socket.

Andreasen JO, Andreasen FM. Classification, Etiology and Epidemiology. In: Andreasen JO, Andreasen FM. Text Book and Color Atlas of Traumatic Injuries to the Teeth. 3rd edn. Denmark: Mosby, 1994: Chapter 3 .

CLASSIFICATIONInjuries to the Supporting Bone Comminution of the Mandibular (N 502.40) or Maxillary (502.40)alveolar socket Crushing and compression of the alveolar socket. This condition is found concomitantly with intrusive and lateral luxations. Fracture of the Mandibular(N 502.60) or Maxillary (N 503.22) alveolar socket wall A fracture confined to the facial or oral socket wall.

Andreasen JO, Andreasen FM. Classification, Etiology and Epidemiology. In: Andreasen JO, Andreasen FM. Text Book and Color Atlas of Traumatic Injuries to the Teeth. 3rd edn. Denmark: Mosby, 1994: Chapter 3 .

CLASSIFICATIONInjuries to the Supporting Bone Fracture of the Mandibular(N 502.60) or Maxillary (N 502.40) alveolar process A fracture of the alveolar process which may or may not involve the alveolar socket. Fracture of the Mandible(N 502.61) or Maxilla (N 503.22) A fracture involving the base if the mandible or maxilla and often the alveolar process. The fracture may or may not involve the alveolar socket.Andreasen JO, Andreasen FM. Classification, Etiology and Epidemiology. In: Andreasen JO, Andreasen FM. Text Book and Color Atlas of Traumatic Injuries to the Teeth. 3rd edn. Denmark: Mosby, 1994: Chapter 3 .

CLASSIFICATIONInjuries to Gingiva or Oral Mucosa Laceration of Gingiva or oral Mucosa (S 01.50) A shallow or deep wound in the resulting from a tear, and usually produced by a sharp object. Contusion of Gingiva or Oral Mucosa (S 00.50) A bruise usually produced by impact with a blunt object and not accompanied by a break in the mucosa, usually causing submucosal hemorrhage.

Andreasen JO, Andreasen FM. Classification, Etiology and Epidemiology. In: Andreasen JO, Andreasen FM. Text Book and Color Atlas of Traumatic Injuries to the Teeth. 3rd edn. Denmark: Mosby, 1994: Chapter 3 .

CLASSIFICATIONInjuries to Gingiva or Oral Mucosa Abrasion of Gingival or Oral Mucosa (S 00.50) A superficial wound produced by rubbing or scraping of the mucosa leaving a raw, bleeding surface.

Andreasen JO, Andreasen FM. Classification, Etiology and Epidemiology. In: Andreasen JO, Andreasen FM. Text Book and Color Atlas of Traumatic Injuries to the Teeth. 3rd edn. Denmark: Mosby, 1994: Chapter 3 .

Summary

CLINICAL ASSES

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