tooth trauma: classification and other forms of injuries

Class lll: Exposure of pulp - This also presents with Tooth pain and chance of pulp survival is reduced with time lapse. If the pulp is still alive the treatment is pulpotomy if the pulp is dead RCT can be done and in open apex, apexification is first done followed by RCT.

CLASS IV: Fracture of root - When fracture line is in coronal half of root the treatment is usually extraction as there is a risk of infection of fracture line and lack of support to the tooth. If the fracture line is below gingival crevice or in apical half there is a chance of conserving the tooth by splinting, if pulp does not heal an RCT can be done and endodontic splint used.

CLASS V: Avulsion or complete displacement - This is when the tooth is completely removed from the socket.

The Treatment is along 2 lines.
1. Space maintenance until the permanent succeeds
2. Re- implantation of the avulsed tooth. After re- implantation RCT may have to be carried out on the tooth.
It must be emphasized that in these cases a good history need to be taken and investigation by radiograph and vitality testing is essential for all the cases also a careful inspection of the socket for fragments is important.

Other forms of tooth trauma

1. Injuries to the developing teeth:This may lead to dilacerations I.e bending of the root of the developing tooth.
2. Injuries to the periodontal membrane: There may lead to tearing of the membrane and bleeding. These may be swelling of the membrane, partial extrusion of the tooth and acute periodontitis.
3. Injuries to the bone: This may involve the dental alveolar bone 2 or more teeth in segment move in unison. This is usually treated by splinting to immobilize for at least 2 weeks for other bones of the face ideal treatment is reduction and immobilization of fragments for 6 weeks.