present a followup schedule for patients who have sustained dental injuries

1. PFa

2. Outline
1. Abbreviations
2. Definitions
3. Introduction
4. Follow-up schedule for dental injuries – Permanent
teeth
5. Follow-up schedule for dental injuries – Primary
teeth
6. References
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3. Abbreviations
 RCT = Root canal treatment
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4. Definitions
 Follow-up - a further examination or
observation of a patient in order to monitor the
success of earlier treatment.
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5. Definitions continued…
 Schedule - a list of planned activities or things to
be done showing the times or dates when they
are intended to happen or be done
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6. Definitions continued..
 Dental injuries - Dental trauma refers
to trauma (injury) to the teeth
and/or periodontium (gums, periodontal
ligament, alveolar bone), and nearby soft
tissues such as the lips, tongue, etc. The study of
dental trauma is called dental traumatology.
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7. Introduction
 Following up on patients who have undergone dental
injuries is important as it may show healing progress
or worsening of the situation – which can therefore
be dealt with by the dentist earlier rather than
waiting until it is too late.
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8. Introduction continued…
 There are different time schedules for follow-up of
each dental injury that depend upon the predicted
time it takes for healing to take place, and for
possible complications to take occur.
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9. Introduction continued…
 Adhering to these follow-up schedules can help to
prevent any possible complications that could
occur after a dental injury.
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10. Follow-up schedule for
dental injuries of
Permanent teeth
Hard tooth structure
Supporting structures
Supporting bone
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11. Enamel infraction
 No follow-up needed unless associated with a
luxation injury or other fracture types involving
the same tooth
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12. Enamel fracture
 Follow-up for clinical and radiographic control at
6-8 weeks and 1 year.
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13. Enamel-dentine fracture
 Follow up for clinical and radiographic control 6-8
weeks and 1 year
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14. Enamel-dentine fracture with pulp
involvement
 Follow-up for clinical and radiographic control at
6-8 weeks and 1 year.
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15. Crown root fracture with or
without pulp exposure
 No follow up
 Follow up for prosthesis
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16. Root fracture
 Follow-up for splint removal, clinical and
radiographic control after 4 weeks in apical third
and mid root fracture.
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17. Root fracture continued…
 However if the root fracture is near cervical area
the splint should be kept on for up to 4 months.
 Clinical and radiographic control after 6 to 8 weeks
 Clinical and radiographic control after 6 months, 1
year and yearly for five years.
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18. Root fracture continued…
 Follow up may include endodontic treatment of
the coronal fragment of pulp necrosis develops.
 The decision for endodontic treatment may be
taken after 3 months if the tooth does not still
respond to electrometric or thermal pulp testing
and if radiograph shows a radiolucency next to the
fracture line.
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19. Supporting structures
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20. Concussion
 Follow up clinical and radiographic control at 4
weeks, 6 to 8 weeks and 1 year.
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21. Subluxation
 Follow up for splint removal and radiographic
control after 2 weeks.
 The clinical and radiographic control at 2 weeks, 4
weeks, 6 to 8 weeks and 1 year.
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22. Extrusion
 Follow up for clinical and radiographic control and
splint removal after two weeks.
 Clinical and radiographic control at 4 weeks, 6 to 8
weeks, 6 months, 1 year and yearly for five months.
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23. Lateral Luxation
 Follow up clinical and radiographic control after 2
weeks.
 Clinical and radiographic control and splint
removal after 4 weeks.
 Clinical and radiographic control after 6 to 8
weeks, 6 months, 1 year and yearly for five years.
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24. Intrusion
 Clinical and radiographic control after 2 weeks
 Splint removal and radiographic control after 4
weeks, 6 to 8 weeks , 6 months, 1 year and yearly
for five years.
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25. Avulsion - closed root apices
 RCT after 7-10 days after replantation.
 Splint removal and clinical and radiographic
control after 2 weeks.
 Clinical and radiographic control after 4 weeks, 3
months, 6 months, 1 year, the yearly thereafter.
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26. Avulsion – root apices not closed
 Avoid RCT unless there is clinical or radiographic
evidence of pulp necrosis.
 Splint removal, clinical and radiographic control after
2 weeks.
 Splint removal, clinical and radiographic control after
4 weeks, 3 months, 6 months, 1 year and yearly there
after years.
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27. Supporting bone
structures
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28. Alveolar fracture and Jaw fracture
 Splint removal and clinical and radiographic control
after 4 weeks.
 Clinical and radiographic control after 6 to 8 weeks, 4
months , 6 months, 1 year, and yearly for five years.
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29. Follow-up for Primary
teeth
 Hard tooth structures
 Supporting structures
 Supporting bone
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30. Hard tooth structures
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31. Enamel infraction and Enamel
fracture
 No follow-up needed unless associated with a luxation
injury or other fracture types involving the same tooth.
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32. Enamel-dentine fracture
 Clinical control at 3 to 4 weeks.
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33. Enamel-Dentine-Pulp fracture
(complicated)
 Follow up, clinical control after 1 week.
 Clinical and radiographic control after 6 to 8 weeks,
and 1 year
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34. Crown-Root Fracture with or
without pulp involvement
 In case of fragment removal only:
 Clinical control after 1 week,
 Clinical and radiographic control after 3-4
weeks.
 Clinical control after 1 year.
 In case of tooth extraction:
 Clinical and radiographic control at 1 year and
every year until eruption of permanent
successor.
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35. Root fracture
 Clinical control after 1 week.
 Clinical and radiographic control after 6-8 weeks and 1
year.
 In case of tooth extraction: clinical and radiographic
control at 1 year and every year until eruption of the
permanent successor.
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36. Alveolar fracture
 Clinical control after 1 week
 Clinical and radiographic control and splint removal
after 3-4 weeks
 Clinical and radiographic control after 6-8 weeks and 1
year and then yearly until exfoliation
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37. References
 https://www.google.co.uk/search?site=&source=hp&q
=follow-up&oq=follow-
up&gs_l=hp.3..0l10.1671.3933.0.4209.9.8.0.1.1.0.456.829
.3-1j1.2.0....0...1c.1.64.hp..6.3.833.XhU0bGMKvFk
 http://dictionary.cambridge.org/dictionary/english/sc
hedule
 https://en.wikipedia.org/wiki/Dental_trauma
 http://www.dentaltraumaguide.org
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38. Thank you for listening
– questions,
comments, concerns?

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