TRAUMATIC

INJURIES TO THE
PRIMARY
DENTITION
DEFINITION:

Traumatic : It means pertaining to or occuring as a result of

or causing trauma.

Injury : It refers to a damage or an insult substain by the

tissue it may evoke dystrophic and / or inflammatory response
from the affected part.

Traumatic injury : damage to a part of the body tissue.

EPIDERMIOLOGY:

Age distribution:
child in the age group 2-4 years
school going child in the age group 8-11 years
Sex:
boys- 31-40%
girls-16-30%
Teeth involved:
upper central incisor-37%
lower central incisor-18%
lower lateral incisors-6%
upper central incisors-3%
Seasonal variation:
frequency of injuries increase during
the winter
etiology
• fall-running,bicycle
• accident
• sports
DIFFERENT TYPES TRAUMATIC
INJURIES IN PRIMARY DENTITION
ENAMEL FRACTURE
INVOLVING THE
MAXILLARY RIGHT
INCISOR.

ENAMEL FRACTURE
INVOLVING MESIAL
ASPECT OF RIGHT CI
& MORE DAMAGETO
LEFT CI
FRACTURE INVOLVING ENAMEL , DENTIN IN
LEFT CI

CORONAL FRACTURE IN RIGHT & LEFT CI

INVOLVING ENAMEL , DENTIN
 FRACTURE INVOLVING
ENAMEL ,DENTIN & PULP
IN THE RIGHT CI

CORONAL
FRACTURE IN LEFT
CI INVOLVING
ENAMEL , DENTIN ,
& PULP
 DISPLACEMENT OF
THE TOOTH
WITHOUT
FRACTURE OF THE
CROWN & ROOT IN
LEFT CI

TRAUMATIZED TOOTH
THAT BECOME NON –
VITAL THAT WITH OR
WITHOUT LOSS OF
CROWN STRUCTURE IN
RIGHT CI
 TOOOTH LOST AS
A RESULT OF
TRAUMA IN RIGHT
CI

FRACTURE OF THE
ROOT
 LUXATION INJURIES

LUXATION :
It is the dislocation or
disarticulation of teeth which are
abnormally mobile and displaced
there may be a partial or complete
necrosis of the pulp.
CONCUSSION : It is a minor injury with minimal injury to
the tooth & periodontal tissue.

Clinical features :
pain

Examination :
sensitive to both horizontal vertical percussion.
sensitive to biting forces.
Radiographic features :

Widening of the Internal root

periodontal ligament resorption
space
SUBLUXATION : It is an injury to the supporting
structure of the tooth results in abnormal loosening of
tooth without frank dislocation.
Treatment :

To avoid biting direction on damage tooth.

Maintenance of soft diet for few days.
Analgesics.
INTRUSIVE LUXATION :It is the displacement of tooth
into the alveolar bone.
EXTRUSIVE LUXATION: Partial displacement tooth out
of the socket
LATERAL DISPLACEMENT: Movement of the tooth
other than axial displacement.
Clinical features :

mobility
bleeding from gingival cravice
Sensitive to the percussion & biting forces
Radiographic features :

Depressed position of Increase width of the

the crown with PDL space
fracture of the
incisal edge
 Treatment :
digital pressure

Composite resin & wire splint splinting

• AVULSION:It is complete
displacement of tooth from its
alveolus
• Clinical features :
• more in maxillary anterior
teeth
• more in young age
•
RADIOGRAPHIC FEATURES:
CLINICAL EVALUATION:

• MEDICAL HISTORY
• EXAMINATION
EXAMINATION:
RADIOGRAPHIC EVALUATION-
INTRAORAL RADIOGRAPH
EXTRAORAL RADIOGRAPH:

ORTHOPANTOGRM (OPG)
VITALITY TEST:

»
SPECIAL TEST:

• MECHANICAL VITALITY TEST

• LASER DOPPLER FLOWMETER
• PULSE OXIMETER
TRETMENT PLAN:
• EMERGENCY TREATMENT-
• Clearance of the airway
• Control of bleeding
• Site of injury should be cleaned with 2%
sol
of sodium bicarbonate
INTERMEDIATE TREAMENT-
If the tooth become vital then esthetic
restoration should be done
If the tooth become nonvital pulp therapy
should be done