Dental Trauma

• dental contusion

• dento-alveolar luxation

• teeth fractures

• late post-traumatic lesion

 Dental contusion
• Excessive use of the dento-alveolar ligament system with
tearing of some ligament fibres or some dento-alveolar inserts

• Oedema in the periodontal space

• integrity of the tooth with in-situ position in the socket

RX:

• discrete enlargement of the apical periodontal space

• ± slight dislocation in mm of the tooth occlusaly

• In time – loss of the tooth vitality

 Incomplete Luxation
• Root displacement inside its socket:
• oral, buccal, mesial, distal, intrusion,
extrusion

• ± fracture of the interdental septum and the

V/O crest

Rgr:
• Extrusion: enlargement of the periodontal
space, uneven occlusal line
• Intrusion: disappearance of the periapical
space and fracture of the nasal floor or of
the maxillary floor
 Complete Dental Luxation (avulsion)

• Expulsion of the from its socket

• Homogeneous radiolucent space of the empty

socket, without the tooth root, well marked by
lamina dura
 Dental fractures
Crown
• Fissures in the enamel or both enamel
and dentine Rx:
• bite wing, rgr. periapical, CBCT

Classification:
• Partial: without pulp chamber
involvement in (non-penetrative); lacunar
image at crown periphery jagged
(irregular) contour

• Total: pulp chamber involved

(penetrative), coexistent apical or
marginal parodontal lesions
 Crown-root fractures

• Causes:
• hard foods,
• endodontic devices,
• profound caries that lowers the tooth resistance
• Trauma, agressions
 Root fractures
• Cervical

• In medium 1/3

• In apical 1/3

• Transversal

• Oblique

• Vertical
 Root fractures
• Clinical:

• coronal fragment mobile, possible crown discolouration

• pain
• fracture path involves cementum, dentine and root
pulp
• despite the severity of this trauma, in 70% of cases
high chances of pulp regeneration (Cvek 2001)
 Root fractures
• may be unnoticeable radiological in the first days

• 2 radiography must be indicated –

- one normally vertical angulated, isometrical,

- second with ±15-20 angulation

• CBCT - superior accuracy than intraoral rgr in detecting

root fractures (Bornstein, 2009)

its accuracy decreases in the presence of endodontic

treatm. (due to artefacts)
Root fractures
 TRAUMA
• Root fractures
 Post-traumatic radiological aspects

• Pulp modifications – pulp chamber

and root canals condensation

• Root modifications
• of the tooth apex
• dentine sponging
• lateral-root modifications
• internal root resorptions

• Alveolar traumatic lesions

 Alveolar fractures
• Fractures of the interdental septum:
• oblique, horizontale, plucks
• angulations or teeth inclinations

• Fractures of the V/O plates

• Accompanied by dental avulsion
• in frontal teeth
• Horizontal fractures, alveolar crest has an irregular
contour, lowered