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Dental trauma 2: acute management of fracture injuries

From Volume 43, Issue 10, December 2016 | Pages 916-926

Authors

Serpil Djemal

BDS, MSc, MRD, RCS, FDS (Rest dent), RCS Dip Ed

Consultant in Restorative Dentistry, King's College Hospital, London SE5 9RS, UK

Articles by Serpil Djemal

Parmjit Singh

Specialist Registrar, The Ipswich Hospital and The Royal London Hospital

Articles by Parmjit Singh

Nectaria Polycarpou

Consultant in Endodontics, Department of Restorative Dentistry, King's College Hospital Dental Institute, London SE5 9RW, UK

Articles by Nectaria Polycarpou

Rachel Tomson

Consultant in Endodontics, Department of Restorative Dentistry, King's College Hospital Dental Institute, London SE5 9RW, UK

Articles by Rachel Tomson

Martin Kelleher

MSc, FDSRCS, FDSRCPS, FCGDent

Specialist in Restorative Dentistry and Prosthodontics, Consultant in Restorative Dentistry, King's College Dental Hospital

Articles by Martin Kelleher

Email Martin Kelleher

Abstract

Fortunately, traumatic dental injuries are a relatively uncommon occurrence in general dental practice. However, when they do present, timely diagnosis and treatment of such injuries is essential to maximize the chance of a successful outcome. This is the second part of a two-part series on traumatic dental injuries that are commonly encountered in the clinical setting. Part one covered the management of acute luxation/displacement injuries affecting the supporting structures of the tooth, while part two will cover the management of fracture injuries associated with teeth and the alveolar bone.

CPD/Clinical Relevance: Traumatic dental injuries are uncommon occurrences in everyday general dental practice. This article aims to provide a simple, step-by-step approach in the diagnosis and clinical management of acute fracture injuries.

Article

This is the second part of a two-part series on traumatic dental injuries. Part one focused on acute management of luxation/displacement dental injuries. Part two will deal with the acute management of dental fractures.

Fracture injuries usually affect the substance of the tooth itself and/or the supporting alveolar bone. These injuries include infraction, enamel fracture, enamel-dentine fracture, enamel-dentine-pulp fracture, crown-root fracture with or without pulpal involvement and root fracture. Fracture injuries also include dento-alveolar fractures and jaw fractures, but the latter are outside the scope of this article and patients with a suspected jaw fracture should be referred to the nearest oral and maxillofacial unit.

Traumatic dental injuries do not always occur in isolation and often present as multiple injury types in one or multiple teeth. A patient could attend with a cervical third root fracture on one tooth and an enamel and dentine fracture on another, while another patient could present with a lateral luxation injury together with an enamel, dentine and pulp fracture associated with the same tooth.

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