Primary Trauma

Primary Trauma

Crown Fracture
1. Enamel #
  1. Check for missing fragments
  2. Smooth sharp edges
  3. No review
2. Enamel-dentine #
  1. GIC bandage
  2. Review
    1. 3-4 wks
3. Enamel-dentine-pulp #
  1. Cooperative
    1. Direct pulp cap or Pulpotomy
    2. Review
      1. 1 wk
      2. 6-8 wks, 1 yr
  2. Uncooperative
    1. Extract
    2. Review
      1. 1 wk
Periodontium injury
1. Concussion
  1. No treatment
  2. Review
    1. 1 wk, 6-8 wks
2. Advice
  1. Soft diet
  2. Keep tooth clean
  3. Chx (0.1%)
    1. Use on cotton wool swab 2 x day
  4. Painkillers
3. Subluxation
  1. No treatment
  2. Review
    1. 1 wk, 6-8wks
4. Complications
  1. Sinus
  2. Mobility
  3. Discolouration
5. Extrusion
  1. Minor (<3mm)
    1. Spontaneous repositioning
    2. Review
      1. 1 wk
      2. 6-8wks, 6m, 1yr
  2. >3mm
    1. Extract
    2. Review
      1. 1 wk
6. Avulsion
  1. Do not re-implant
  2. Review
    1. 1 wk
    2. 6m,1yr, yearly until successor erupts
7. Intrusion
  1. Crown palatal & Apex labial
    1. Spontaneous repositioning
    2. Review
      1. 1 wk
      2. 3-4wk, 6-8wks, 6m, 1yr, yearly until eruption of successor
  2. Crown labial & Apex palatal (into successor germ)
    1. Extract
    2. Review
      1. 1wk, 1yr
    3. Risk of damage to successor
      1. Crown/root dilaceration
      2. Altered eruption
      3. Hypoplasia
8. Lateral luxation
  1. No occlusal interference (AOB)
    1. Spontaneous reposition
  2. Occlusal interference
    1. Surgically reposition
  3. Severe / apex palatal
    1. Extract
    2. Risk of damage to successor
  4. Review
    1. 1wk, 2-3wks
    2. 6-8wks, 1yr
Root Fracture
1. Coronal fragment not displaced/mobile
  1. No treatment
2. Coronal fragment displaced/mobile
  1. Extract coronal fragment (leave root)
    1. Review
      1. 1wk
      2. 1yr
    2. Warn of risk of infection (of root)
    3. Greater risk of damaging successor if attempt root removal
Avleolar Fracture
1. Reposition segement
2. Often need GA
3. Flexible splint for 4wks
4. Review
  1. 1wk
  2. 4wks
  3. 6-8wks, 1yr, yearly until exfoliation

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