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DTGL

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shaimaa sabry

on 24 August 2016

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Transcript of DTGL

Evidence behind
Dental Trauma Guidelines

Shaimaa M. Sabry
Pulpectomy
Pulp Exposed
Dentine Exposed
Rough Enamel edges
No ttt
Smooth off the edge
Resin Composite
What if the fracture line is extended to the root?
Fragment removal & gingivectomy (sometimes ostectomy)
Orthodontic extrusion
weak
Surgical extrusion
Decoronation (Root submergence)
Coronectomy
Guidlines are based on a review of the current dental and medical literature related to dental trauma.
An electronic search was conducted using the following parameters:
Terms: “teeth”, “trauma”, “permanent teeth”, and “primary teeth”
Fields: all
Limits: within the last 10 years, humans, English.

The results of the search:
5269 articles
Recommendations based upon:
expert opinion
consensus opinion in “Symposium on Trauma: A Comprehensive Update on Permanent Tooth Trauma in Children” ( AAPD, 2008 )
The recommendations are in agreement with
the guidelines of the International Association of Dental Traumatology, 2007
In addition to..
A review of the journal Dental Traumatology 2000-2009.
When data were insufficient or inconclusive:
Permanent teeth
Tooth Avulsion
Crown Fractures
Primary teeth
Root Fractures
1- Re-approximate.
2- splinting:
Fracture in middle of the root: Physiologic splint (40 pound test fishing line or light stainless steel wire for
4 weeks.

Fracture in coronal 1/3 of the root: Rigid splint (Resin or wire composit splint)

for
8 - 12 weeks
Weak
Intrusive Injuries
Extraction
Spontanous eruption
Location of fracture line
Degree of mobility
Direction of the intrusion
Apex
Intrusion severity
Luxation / Extrusion Injuries
(cc) photo by medhead on Flickr
Degree of tooth mobility
Occlusal Interference
Lateral luxation
Extrusion
Primary Teeth
The main goal is:

To reposition & splint the tooth
Proper pulp ttt.
Crown-root fracture
Crown fractures
Crown Fractures
Root Fractures
Root Fracture
Luxation / Extrusion Injuries
Luxation / Extrusion Injuries
Intrusive Injuries
Intrusive Injuries
Maintain pulp vitality

Restore normal esthetics
and function
Tooth Avulsion
Tooth Avulsion
Frist step in Management
Comfort
the patient and his parents first.

Clean
the face and the oral cavity with water or saline

Make a short medical and dental
history

Question..
Where
did the injury occur?

How
did the injury occur?

When
did the injury occur?

Was there
loss of consciousness
,
headache
,
nausea
,
vomitting
,
blurred vision
?
"Brain Concussion"

Is there any
Fluid/ blood leakage
from the nose or the ear ?
“Fracture of the base of the skull”
ب

Clinical Examination
Palpate the
facial skeleton.






Examin
face
,
lips
and
oral musculature
for soft tissue lesions
Teeth
:
1- Visual examination
2- Percussion test
3- Mobility test
4- Sensibility pulp test

Radiograpgic Examination
1.
Periapical
bisecting angle.


2. One
steep occlusal
exposure.




3. Radiographic examination of
soft tissue
lesions.
Full transcript