This document discusses the treatment of traumatic dental injuries. It recommends repositioning displaced teeth with light pressure and stabilizing them for 3-5 weeks. Teeth with alveolar fractures require heavier stabilization for 6 weeks. Light orthodontic forces may later be used, as heavy forces could damage traumatized teeth. Follow-up x-rays at intervals are advised to check for pathology. Intruded or extruded teeth should be repositioned promptly when possible. Primary failure of eruption may require prosthetics or surgery if teeth do not respond to orthodontic traction. Transpositions can sometimes be corrected early via orthodontics or later require tooth movement or reshaping.

1. B Y
P R O F . S H A H A B A D I L
Traumatic Displacement of
Teeth

2. Traumatic Displacement of Teeth
 After trauma tooth is repositioned to its near normal
position with finger pressure out of occlusal
interferences and stabilized with a light wire for 3-5
weeks
 If alveolar bone is also fractured then teeth should be
stabilized with heavy for 6 weeks

3.  Orthodontic light forces should be used after trauma
for final alignment because heavy force may lead to
loss of vitality and root resorption in previously
traumatized teeth or if occur during orthodontic
treatment

4.  Periapical radiograph follow up should be done at 2-
3 weeks, 6-8 weeks and 1 year for periapical
pathology
 In case of loss of vitality or evidence of root
resorption, root canal treatment should be
immediately started

5.  Traumatically intruded teeth should be observed for
3 weeks to see if it re erupts by itself or it will need
orthodontic or surgical repositioning
 7mm intrusion of tooth with open apices and mm
intrusion of tooth with closed apices are difficult to
correct with orthodontics only surgical intervention
will be needed

7.  In case or extrusive injuries or evulsion try to back
tooth to its normal position as soon as possible
 Orthodontic intrusion later on will result in vertical
boney defect
 In severe cases tooth can be root treated and then
decoronated to reserve ridge for future prosthesis

9. Primary Failure of Eruption
 When posterior teeth fail to erupt without any
mechanical obstruction or ankylosis
 Little or no response to orthodontic traction and may
get ankylosed
 Genetic etiology

11.  Either accept premolar to premolar occlusion
 Or consider prosthesis, segmental osteotomies and
distraction osteogenesis can be consider in mild
cases

12. Transposition
 Rare Positional interchange of two adjacent teeth
 Prevalence 0.3%
 Mandibular incisors and maxillary premolars are
commonly effected usually occurs as a result of
ectopic eruption

13.  Early intervention can avoid true transposition
 In case of late intervention bodily movement of the
transposed teeth may be needed or partially
transposed tooth can be moved to full transposition
and then reshaping will be needed.