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Traumatic Injuries To The Teeth PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Traumatic injuries to the teeth” by Dr. Rajeev Kumar Singh.

This medical PowerPoint presentation is about traumatic injuries to the teeth which can occur due to accidents, falls, sports injuries, and other types of trauma to the face or mouth. These injuries can range from minor chips and cracks to more severe damage, such as broken teeth or completely knocked-out teeth. Here are some common types of traumatic injuries to the teeth:

Fractured teeth: A fractured tooth can result from a blow to the face, a fall, or biting down on something hard. The severity of the fracture will determine the appropriate treatment, which may range from a filling or bonding to a crown or extraction.
Knocked-out teeth: When a tooth is completely knocked out of its socket, it is called an avulsed tooth. This can occur due to a hard hit to the face or a fall. It is important to seek immediate dental care as the tooth may be re-implanted if it is handled properly and re-implanted within a certain time frame.
Chipped or cracked teeth: Minor chips and cracks can often be repaired with cosmetic dental procedures such as bonding or veneers. However, if the damage is more extensive, a crown or other restorative treatment may be necessary.
Root fractures: A root fracture occurs when the root of a tooth is broken. Depending on the severity of the fracture, the tooth may require a root canal or extraction.
Luxated teeth: A luxated tooth is one that has been pushed out of its normal position but is still attached to the socket. Treatment may involve repositioning the tooth and splinting it in place to allow for healing.

If you experience a traumatic injury to your teeth, it is important to seek dental care as soon as possible. Prompt treatment can help to save the tooth and prevent further damage or infection.

Tags : traumatic injuries to the teeth, Fractured teeth, Knocked-out teeth, Chipped or cracked teeth, Root fractures, Luxated teeth, Dentistry, dental medicine, oral medicine, dental medicine PowerPoint presentation

Published on : Jun 20, 2023 | Views : 2561 | Downloads : 10

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Slide 1-

Traumatic injuries to the teeth Presented by: Dr. Rajeev Kumar Singh
Slide 2-

Definitions Trauma a physical injury or wound to the body Traumatic relating to physical injuries or wounds to the body Traumatology the branch of medicine that deals with serious injuries and wounds and their long-term consequences
Slide 3-

Epidemiology Dental trauma is common in childhood & adolescent Incidence of dental trauma is 31-40% of boys & 16-30% of girls at 5 years of age Incidence of dental trauma is 12-33% of boys & 4-19% of girls at 12 years of age Boys are affected almost twice as often as girls in both the dentitions
Slide 4-

Etiology Most accident prone age is between 2 & 4 years for the primary dentition & 7 & 10 years for the permanent dentition Pre-School Child: Fall injuries. Child abuse. Injury during play. Seizures. School Age: Athletic injuries. Fighting. Auto accidents. Seizure disorders.
Slide 5-

Type of trauma Direct trauma : When the tooth itself is struck Indirect trauma: When the lower dental arch is forcefully closed against the upper
Slide 6-

Ellis classification Class I: Enamel fracture Class II: Enamel and dentin fracture without pulp exposure Class III: Crown fracture with pulp exposure Class IV: Traumatized tooth that has become non-vital with or without loss of tooth structure Class V: Teeth lost as a result of trauma (Avulsion) Class VI: Fracture of root with or without loss of crown structure Class VII: Displacement of the tooth without fracture of crown or root Class VIII: Fracture of the crown en masse and its replacement Class IX: Fracture of deciduous teeth
Slide 7-

CLASS I A fracture confined to the enamel with loss of tooth structure Enamel fracture
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Class II A fracture confined to enamel and dentin with loss of tooth structure but not involving the pulp Enamel-dentin fracture
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Class III A fracture involving enamel and dentin with loss of tooth structure and exposure of the pulp Enamel-dentin-pulp fracture
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Tooth becomes non-vital Class IV Traumatized tooth that has become non-vital with or without loss of tooth structure
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Class V Teeth loss due to trauma Avulsion
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Class VI Fracture of root with or without loss of crown structure Root Fracture
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Tooth displacement Class VII Displacement of the tooth without fracture of crown or root
Slide 14-

Fracture of crown en masse or its replacement Class VIII Complete fracture of the crown
Slide 15-

Class IX Injuries to the primary teeth Any injury to the primary tooth
Slide 16-

Treatment of various dental fractures
Slide 17-

Management of Class 1 fracture If a tooth fragment is available, it can be bonded to the tooth. In many cases no immediate treatment is needed other than smoothing of sharp fracture edges. The fracture can be left for later restoration which in most cases will consist of augmentation with composite resin material. Grinding or restoration with composite resin depending on the extent and location of the fracture. Clinical and radiographic control at 6-8 weeks and 1 year.
Slide 18-

If a tooth fragment is available, it can be bonded to the tooth. Otherwise perform a provisional treatment by covering the exposed dentin with glass-ionomer or a permanent restoration using a bonding agent and composite resin. The definitive treatment for the fractured crown is restoration with accepted dental restorative materials. Radiograph of lip or cheek lacerations to search for tooth fragments or foreign material Follow-up Clinical and radiographic control at 6-8 weeks and 1 year Management of Class 2 fracture
Slide 19-

Management of class III fracture Factors affecting management of class III fractures Vitality of the pulp Size of pulp exposure Time elapsed since exposure Stage of development of root apex Restorability of fractured crown
Slide 20-

Closed apex Open apex RCT Vital tooth Non-vital tooth Direct Pulp Capping Pulpotomy Apexification Treatment summary for class III fractures
Slide 21-

Closed apex Open apex RCT Apexification Class IV fracture
Slide 22-

Treatment of Class V fracture (Avulsion) Factors affecting management of class V fracture Time interval between injury and treatment Conditions under which the tooth is stored
Slide 23-

Instructions to the patient on Telephone
Slide 24-

First aid for avulsed teeth Keep the patient calm Find the tooth & pick it up by the crown Clean the tooth Place the tooth in a suitable storage medium Seek emergency dental treatment immediately
Slide 25-

Storage media for avulsed tooth Tissue or cell culture media like Hank’s Balanced salt Solution (HBSS) Milk Isotonic Saline Contact lens solution Buccal vestibule or under the tongue Unsalted water Saliva
Slide 26-

Treatment of Avulsion Tooth replanted prior to the patient's arrival at the dental clinic Extraoral dry time less than 60 min. The tooth has been kept in suitable storage media and/or stored dry less than 60 minutes. Extraoral dry time exceeding 60 min or other reasons suggesting non-viable cells Tooth replanted prior to the patients arrival at the dental clinic Extraoral dry time less than 60 min. The tooth has been kept in suitable storage media and/or stored dry less than 60 minutes. Dry time longer than 60 min or other reasons suggesting non-viable cells Closed Apex Open apex
Slide 27-

Closed Apex Leave the tooth in place. Clean the area with water spray, saline, or chlorhexidine. Suture gingival lacerations if present. Verify normal position of the replanted tooth both clinically and radiographically. Apply a flexible splint for up to 2 weeks. Administer systemic antibiotics. If the avulsed tooth has been in contact with soil, and if tetanus coverage is uncertain, refer to physician for a tetanus booster. Initiate root canal treatment 7-10 days after replantation and before splint removal. Tooth replanted prior to the patient's arrival at the dental clinic
Slide 28-

Patient instructions Avoid participation in contact sports Soft food for up to 2 weeks Brush teeth with a soft toothbrush after each meal Use a chlorhexidine (0.1 %) mouth rinse twice a day for 1 week.
Slide 29-

Root canal treatment 7-10 days after replantation. Place calcium hydroxide as an intra-canal medicament for up to 1 month followed by root canal filling with an acceptable material. Alternatively an antibiotic-corticosteroid paste may be placed immediately or shortly following replantation and left for at least 2 weeks. Splint removal and clinical and radiographic follow-up after 2 weeks. Clinical and radiographic follow-up after 4 weeks, 3 months, 6 months, 1 year and then yearly thereafter. Follow-up
Slide 30-

Extra-oral dry time less than 60 min. The tooth has been kept in suitable storage media and/or stored dry less than 60 minutes Clean the root surface and apical foramen with a stream of saline and soak the tooth in saline thereby removing contamination and dead cells from the root surface. Administer local anesthesia Irrigate the socket with saline. Examine the alveolar socket. If there is a fracture of the socket wall, reposition it with a suitable instrument. Replant the tooth slowly with slight digital pressure. Do not use force. Closed apex
Slide 31-

Suture gingival lacerations if present. Verify normal position of the replanted tooth both, clinically and radiographically. Apply a flexible splint for up to 2 weeks, keep away from the gingiva. Administer systemic antibiotics. If the avulsed tooth has been in contact with soil, and if tetanus coverage is uncertain, refer to physician for a tetanus booster. Initiate root canal treatment 7-10 days after replantation and before splint removal. Closed apex Extra-oral dry time less than 60 min. The tooth has been kept in suitable storage media and/or stored dry less than 60 minutes
Slide 32-

Patient instructions Avoid participation in contact sports Soft food for up to 2 weeks Brush teeth with a soft toothbrush after each meal Use a chlorhexidine (0.1 %) mouth rinse twice a day for 1 week.
Slide 33-

Root canal treatment 7-10 days after replantation. Place calcium hydroxide as an intra-canal medicament for up to 1 month followed by root canal filling with an acceptable material. Alternatively an antibiotic-corticosteroid paste may be placed immediately or shortly following replantation and left for at least 2 weeks. Splint removal and clinical and radiographic follow-up after 2 weeks. Clinical and radiographic follow-up after 4 weeks, 3 months, 6 months, 1 year and then yearly thereafter. Follow-up
Slide 34-

Extra-oral dry time exceeding 60 min or other reasons suggesting non-viable cells Delayed replantation has a poor long-term prognosis. The periodontal ligament will be necrotic and can not be expected to heal. The goal in delayed replantation is, in addition to restoring the tooth for esthetic, functional and psychological reasons, to maintain alveolar bone contour. However, the expected eventual outcome is ankylosis and resorption of the root and the tooth will be lost eventually. Closed Apex
Slide 35-

Remove attached non-viable soft tissue carefully, with gauze. Root canal treatment can be performed prior to replantation, or it can be done 7-10 days later. Administer local anesthesia & Irrigate the socket with saline. Examine the alveolar socket. If there is a fracture of the socket wall, reposition it with a suitable instrument. Replant the tooth slowly with slight digital Do not use force. Suture gingival lacerations if present. pressure. Closed Apex Extra-oral dry time exceeding 60 min or other reasons suggesting non-viable cells
Slide 36-

Verify normal position of the replanted tooth clinically and radiographically. Stabilize the tooth for 4 weeks using a flexible splint. Administer systemic antibiotics. If the avulsed tooth has been in contact with soil, and if tetanus coverage is uncertain, refer to physician for a tetanus booster. To slow down osseous replacement of the tooth, treatment of the root surface with fluoride prior to replantation has been suggested (2 % sodium fluoride solution for 20 min. Closed Apex Extra-oral dry time exceeding 60 min or other reasons suggesting non-viable cells
Slide 37-

Patient instructions Avoid participation in contact sports Soft food for up to 2 weeks Brush teeth with a soft toothbrush after each meal Use a chlorhexidine (0.1 %) mouth rinse twice a day for 1 week.
Slide 38-

Root canal treatment 7-10 days after replantation. Place calcium hydroxide as an intra-canal medicament for up to 1 month followed by root canal filling with an acceptable material. Alternatively an antibiotic-corticosteroid paste may be placed immediately or shortly following replantation and left for at least 2 weeks. Splint removal and clinical and radiographic follow-up after 2 weeks. Clinical and radiographic follow-up after 4 weeks, 3 months, 6 months, 1 year and then yearly thereafter. Follow-up
Slide 39-

Ankylosis is unavoidable after delayed replantation and must be taken into consideration. In children and adolescents ankylosis is frequently associated with infraposition. Careful follow-up is required and good communication is necessary to ensure the patient and guardian of this likely outcome. Follow-up
Slide 40-

Leave the tooth in place. Clean the area with water spray, saline, or chlorhexidine. Suture gingival laceration if present. Verify normal position of the replanted tooth both clinically and radiographically. Apply a flexible splint for up to 1-2 weeks. Administer systemic antibiotics. If the avulsed tooth has been in contact with soil and if tetanus coverage is uncertain, refer to physician for a tetanus booster. The goal for replanting still-developing (immature) teeth in children is to allow for possible revascularization of the tooth pulp. If that does not occur, root canal treatment is recommended. Tooth replanted prior to the patient's arrival at the dental clinic Open apex
Slide 41-

Patient instructions Avoid participation in contact sports Soft food for up to 2 weeks Brush teeth with a soft toothbrush after each meal Use a chlorhexidine (0.1 %) mouth rinse twice a day for 1 week.
Slide 42-

For immature teeth, root canal treatment should be avoided unless there is clinical or radiographic evidence of pulp necrosis. Splint removal and clinical and radiographic control after 2 weeks. Clinical and radiographic control after 4 weeks, 3 months, 6 months, 1 year and then yearly thereafter. Follow-up
Slide 43-

Clean the root surface and apical foramen with a stream of saline. Topical application of antibiotics has been shown to enhance chances for revascularization of the pulp and can be considered if available (minocycline or doxycycline 1 mg per 20 ml saline for 5 minutes soak). Administer local anesthesia. Examine the alveolar socket. If there is a fracture of the socket wall, reposition it with a suitable instrument. Irrigate the socket with saline. Replant the tooth slowly with slight digital pressure. Suture gingival lacerations, especially in the cervical area. Verify normal position of the replanted tooth clinically and radiographically. Apply a flexible splint for up to 2 weeks. Open apex Extra-oral dry time less than 60 min. The tooth has been kept in suitable storage media and/or stored dry less than 60 minutes
Slide 44-

Administer systemic antibiotics. If the avulsed tooth has been in contact with soil and if tetanus coverage is uncertain, refer to physician for a tetanus booster. The goal for replanting still-developing (immature) teeth in children is to allow for possible revascularization of the pulp space. The risk of infection-related root resorption should be weighed up against the chances of revascularization. Such resorption is very rapid in children. If revascularization does not occur, root canal treatment may be recommended. Open apex Extra-oral dry time less than 60 min. The tooth has been kept in suitable storage media and/or stored dry less than 60 minutes
Slide 45-

Dry time longer than 60 min or other reasons suggesting non-viable cells Remove attached non-viable soft tissue with gauze. Root canal treatment can be carried out prior to replantation or later. Administer local anesthesia. Irrigate the socket with saline. Examine the alveolar socket. if there is a fracture of the socket wall, reposition it with a suitable instrument. Replant the tooth slowly with slight digital pressure. Suture gingival lacerations if present. Open apex
Slide 46-

Verify normal position of the replanted tooth clinically and radiographically. Stabilize the tooth for 4 weeks using a flexible splint. Administer systemic antibiotics. If the avulsed tooth has been in contact with soil or if tetanus coverage is uncertain, refer to physician for evaluation of the need for a tetanus booster. To slow down osseous replacement of the tooth, treatment of the root surface with fluoride prior to replantation has been suggested (2 % sodium fluoride solution for 20 min. Open apex Dry time longer than 60 min or other reasons suggesting non-viable cells
Slide 47-

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Slide 48-

MCQS
Slide 49-

Q1- Ellis & Devey classified tooth avulsion in which of the following class: a) Class IV b) Class V c) Class VI d) Class VII
Slide 50-

Q2- According to Ellis & Devey classification, class III fracture of anterior tooth is: a) Enamel and dentin fracture without pulp exposur b) Crown fracture with pulp exposure c) Traumatized tooth that has become non-vital with or without loss of tooth structure d) Fracture of root with or without loss of crown structur
Slide 51-

Q3- Which of the following is treatment of choice for class III fracture in a non vital tooth with open apex: a) RCT b) Direct pulp capping c) Pulpotomy d) Apexification
Slide 52-

Q4- Which of the following is considered best storage media for avulsed tooth: a) HBSS b) Water c) Saliva d) Glycerine
Slide 53-

Q5- which of the following is treatment of choice in a Class III fractured vital tooth with open apex: a) RCT b) Pulpotomy c) Apexification d) No treatment required
Slide 54-

Q6- which of the following is TRUE in a case of avulsed tooth that is replanted immediately: a) There is always peri-dental inflammation b) The socket is prepared by carefully removing the clot and irrigating gently with sterile normal saline c) Reimplantation should occur within 12 hours d) A tooth that has been dry for more than 60 minutes can often be successfully re-implanted
Slide 55-

Q7- Ankylosis of tooth is commonly seen when: a) Extraoral dry time is less than 30 minutes b) Extraoral dry time is more than 30 minutes c) Extraoral dry time is less than 60 minutes d) Extraoral dry time is more than 30 minutes
Slide 56-

Q8- Splinting of teeth in cases of reimplantation in children is recommended for a period of: a) 1-2 weeks b) 2-3 weeks c) 3-4 weeks d) 4-5 weeks
Slide 57-

Q8- Identify the class of fracture in the picture given: a) Ellis Class I b) Ellis Class II c) Ellis Class III d) Ellis Class IX
Slide 58-

Q8- Identify the class of fracture in the x-ray given: a) Ellis Class IV b) Ellis Class V c) Ellis Class VI d) Ellis Class VII