This document discusses the emergency treatment of various types of traumatic dental injuries including crown fractures, root fractures, and avulsed teeth. It provides information on classifying different types of fractures, emergency management procedures like splinting and replantation of avulsed teeth, factors affecting success of replantation, and the importance of follow-up endodontic treatment. It also includes a case report example to illustrate the long-term management and outcomes of a replanted tooth. The goal is to provide dentists with knowledge and skills to successfully manage dental emergencies and trauma cases.

6. Emergency treatment of traumatic
injuries-fractures
 Crown fracture
without pulp exposure
with pulp exposure
with necrotic pulp exposure
 Horizontal root fracture
 Avulsed teeth

7. Crown fracture without pulp
exposure

8. Crown fracture without pulp
exposure

9. Crown fracture with vital pulp
exposure

10. Crown fracture with necrotic pulp
exposure
 Earlier accident
 Caries
 Deep restoration
 Severing of pulpal vessels

11. Horizontal root fracture

12. Management
 Wire composite splint
 Orthodontic bracket splint
 Resin splint
 Titanium trauma splint

13. Titanium trauma splint

14. Avulsion
 Emergency treatment at the site of injury
 Emergency treatment at the dental office
 Completion of endodontic treatment

15. Emergency treatment at the site of
injury
 Tooth replanted as soon as possible
 Reinserted into the socket
 Use of suitable transport media

16. Emergency treatment at the dental
office
 Put the tooth in saline
 Splinted
 Do not curette, sterilize
 Implant the tooth firmly into the socket

17. Avulsion
“complete displacement of the tooth
out of the socket with neither crown
or root fracture”
Incidence:
o 1-16% of all traumatic injuries of permanent
teeth.
o 7-13% of primary dentition
o Male: Female ratio 3:1
o Age group 7-11 yrs
o Maxillary central incisors are commonly
avulsed

18. Avulsion
 Pick up the knocked-off tooth,
Holding the crown without touching the
root
 Best to hold with sterile gauze
 Do not disturb the viability of PDL
 Do not dry the tooth

19. How to store avulsed tooth
Milk or saliva of
injured person
Transport media
Hanks balanced salt solution
(HBSS)
Via span
Saliva
Milk
Water

20. Factors affecting the success of replantation
 Extra oral time
 Shorter the extra oral period, better the
prognosis for retention of the replanted tooth

21. Stabilization
 Wire composite splint
 Orthodontic bracket splint
 Resin splint
 Titanium trauma splint

22. Completion of endodontic
treatment
 Prepare access cavity
 Root canal debridement and preparation
 Place calcium hydroxide paste
 Refresh the canal walls fill with gutta-
percha

23. Case-report
Courtesy –Franklin.s.weine

24. Case report (contd)
Courtesy –Franklin.s.weine
Post obturation 2 years recall
3 years recall 17 years recall

25. Conclusion
 Endodontic emergencies are a challenge for
both diagnosis and management.
 Knowledge and skill in several aspects of
endodontics are required;failure to apply these
will result in serious consequences for the
patient
 It is satisfying and rewarding to successfully
manage a distraught patient who has an
emergency.

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No Compromise Dentistry assisted with
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