The document outlines the epidemiology, etiology, classification, diagnosis, and treatment of various types of traumatic dental injuries. It discusses the mechanisms of dental injuries and provides detailed descriptions of classifications systems like the Ellis classification and Andreasen classification. Guidelines are provided for examining and managing different injuries to hard tissues, pulp, periodontal tissues, supporting bone, and soft tissues like the gingiva.
Trauma To The Permanent Maxillary Incisors In The Mixed Dentition And Orthodo...Mohamed Alkeshan
this presentation talking about treatment traumatic teeth specially maxillary incisor and orthodontic treatment possibility after trauma . dr mohammad alkeshan
Trauma To The Permanent Maxillary Incisors In The Mixed Dentition And Orthodo...Mohamed Alkeshan
this presentation talking about treatment traumatic teeth specially maxillary incisor and orthodontic treatment possibility after trauma . dr mohammad alkeshan
Titanium Button With Chain by Watted For Orthodontic Traction of Impacted Ma...Abu-Hussein Muhamad
Abstract: Advances in bonding techniques and materials allow for reliable bracket placement on ectopically positioned teeth. This prospective study evaluates the outcome of forced orthodontic eruption of impacted canine teeth in both palatal and labial positions. Eighty-two impacted maxillary canines in 2200patients were included in the study and were observed for 2006 to 2013 ,in Center for Dentistry research and Aesthetics, Jatt/Israel after exposure. Following exposure by means of a palatal flap or an apically repositioned buccal flap, an orthodontic traction hook, with a Titanium Button with chain by Watted (Dentaurum) attached, was bonded to each impacted tooth using a light cured orthodontic resin cement. A periodontal dressing was placed over the surgical site for a period of time. All teeth were successfully erupted. Complications consisted of: failure of initial bond, at the time of surgery, which required rebonding; premature debonding at the time of pack removal and; debonding of brackets during orthodontic eruption. There was no infection, eruption failure, ankylosis, resorption or periodontal defect (pocket greater than 3 mm) associated with any of the exposed teeth. Forced orthodontic eruption of impacted maxillary canines with a well bonded orthodontic traction hook and ligation chain, used in conjunction with a palatal flap or an apically repositioned labial flap, results in predictable orthodontic eruption with few complications. Key Words: cuspid/surgery; orthodontics, corrective; tooth, impacted/therapy
Traumatic dental injuries, incidence, classification, and treatment. This seminar is made to help establish the proper diagnosis and management of traumatic dental injuries based on evidence and international guidelines
the aims of orthodontics is to treat protruded teeth to prevent trauma . crowded teeth help initiation of caries so their treatment is indicated by orthodontics
Titanium Button With Chain by Watted For Orthodontic Traction of Impacted Ma...Abu-Hussein Muhamad
Abstract: Advances in bonding techniques and materials allow for reliable bracket placement on ectopically positioned teeth. This prospective study evaluates the outcome of forced orthodontic eruption of impacted canine teeth in both palatal and labial positions. Eighty-two impacted maxillary canines in 2200patients were included in the study and were observed for 2006 to 2013 ,in Center for Dentistry research and Aesthetics, Jatt/Israel after exposure. Following exposure by means of a palatal flap or an apically repositioned buccal flap, an orthodontic traction hook, with a Titanium Button with chain by Watted (Dentaurum) attached, was bonded to each impacted tooth using a light cured orthodontic resin cement. A periodontal dressing was placed over the surgical site for a period of time. All teeth were successfully erupted. Complications consisted of: failure of initial bond, at the time of surgery, which required rebonding; premature debonding at the time of pack removal and; debonding of brackets during orthodontic eruption. There was no infection, eruption failure, ankylosis, resorption or periodontal defect (pocket greater than 3 mm) associated with any of the exposed teeth. Forced orthodontic eruption of impacted maxillary canines with a well bonded orthodontic traction hook and ligation chain, used in conjunction with a palatal flap or an apically repositioned labial flap, results in predictable orthodontic eruption with few complications. Key Words: cuspid/surgery; orthodontics, corrective; tooth, impacted/therapy
Traumatic dental injuries, incidence, classification, and treatment. This seminar is made to help establish the proper diagnosis and management of traumatic dental injuries based on evidence and international guidelines
the aims of orthodontics is to treat protruded teeth to prevent trauma . crowded teeth help initiation of caries so their treatment is indicated by orthodontics
Assessment of oral problems and dental status of autistic children in comparison to a matched group of non-autistic healthy children in Benghazi, Libya.1
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
3. Introduction
↑ traffic accidents & participation in
sports activities have contributed to
making traumatic dental injuries an
emergingpublichealthproblem.
4. Introduction
The emotional impact of such an accident over the child and parents is very
strong.
The dentist must be well informed and capable of an accurate and speedy
diagnosis,followed bydefinitivetherapyleadingtothe finalrestoration.
13. 2)W.H.OClassification(1993):
ClassI:Toothtraumatized withcrownand rootintact.
Class II:Coronalfracture-pulp notexposed.
Class III:Coronalfracture-pulp exposed.
Class IV:Coronalfracture extending subgingivally.
ClassV:Rootfracturewithorwithoutlossofcrownstructure.
Class VI:Displacement ofteethwithorwithoutfracture.
Division(1):PartialDisplacement
A-Labial,lingualorlateral.
B-Extrusion.
C-Intrusion.
Division(2):CompleteAvulsion
Class VII:Injuries todeciduous teeth.
14. 3)Andreasen classification (1981)
A. injuriestohard tissuesandpulp.
B. injuriestoperiodontaltissues.
C. Injuriestosupportingbone.
D. Injuriestogingivaandoralmucosa.
15.
16. A)Injuries tohard tissues andpulp.
1)Infraction
incomplete fracture (crack) of the enamel with
outlossoftoothstructure.
17. A)Injuries tohard tissues andpulp.
2) Crownfracture (uncomplicated)
an enamel or an enamel-dentin fracture that does not involve
the pulp.
18. A)Injuries tohard tissues andpulp.
3) Crown fracture ( complicated) :
an enamel-dentin fracture with
pulp exposure.
24. 3 ) Lateral luxation : displacement of the tooth in
a direction other than axially. The periodontal
ligament is torn and contusion or fracture of the
supporting alveolarboneoccurs.
25. 4) Intrusion : apical displacement of tooth into
socket, compressing the periodontal ligament and
causes acrushing fracture ofthe alveolarsocket.
26. 5) Extrusion : partial displacement of the tooth
axially from the socket; partial avulsion. The
periodontalligamentusuallyistorn.
27. 6) Avulsion : complete displacement of tooth out of
socket. The periodontal ligament is severed and
fracture ofthe alveolusmay occur.
31. Abrasion : superfacial wound in which the epithelial tissue is rubbed or scratched
.
Contusion : is hemorrhage of subcutaneous tissue without laceration of epithelial
tissue .itisusuallycaused bya bluntobject.
Laceration:tearingof tissue usually caused byasharp object.
36. c) ClinicalExamination:
After obtaining the history and recording the chief complaint and ruling out
neurologicaltrauma,thefollowingisstarted:
I- Extra - oral examination : starting with facial bones , wounds and bruises , T.M.J ,
and mandibular function. Any stiffness or pain in child's neck may be due to
cervicalspineinjury.
37. c)ClinicalExamination:
II- Intra-oralexamination :
1) Manipulation of teeth and alveolar process to determine mobility. or presence of
cracks orpulpal hyperemia .
2) Percussion cangiveanideaaboutperiodontalmembrane injury.
3) Vitalitytestisnotveryvaluableespeciallyinprimaryteeth.
4) Permanent teeth which may be in a state of shock may not respond to vitality tests.
Thetestcanberedoneafter7-10 daysoftrauma.
42. A)Injuriestohardtissuesandpulp.
1) Infraction
Definition : incomplete fracture (crack) of the enamel withoutloss of tooth
structure.
Diagnosis:transillumination→crazelinesapparent .
Treatment : only maintain structural integrity and pulp vitality →
Complications areunusual.
43. A)Injuries tohard tissues andpulp.
2) Crownfracture (uncomplicated)
Definition: an enamel fracture or an enamel-dentin fracture that does not involve the
pulp.
Diagnosis: Injured lips, tongue, and gingiva should be examined clinically and by
radiographcsfortoothfragments.
Treatment :
o Forsmall fractures, rough marginsandedges→ smoothing
o Forlarger fractures → protection pulp+composite restoration.
o Thept reexaminedafter2weeksandagainafter1month
53. Stainlesssteelcrown:
restoration in cases of extensive fracture with
vital pulp exposures or emergency treatment
for patientsin hospital .
Its does not provide a means for assessing
pulpal response and it has an unpleasant
appearance.
54. A)Injuries tohard tissues andpulp.
3)Crownfracture (complicated)
Definition:anenamel-dentin fracturewithpulp exposure.
Treatment :
Primary teeth : pulpotomy, pulpectomy, and extraction. Decisions are based on life expectancy of
the tooth and vitality of the pulpal tissue.(Direct pulp capping with calcium
hydroxide is not indicated.)
Permanent teeth : direct pulp capping , partial pulpotomy , full pulpotomy or Pulpectomy ( root
canaltherapy).
prognosis : depend upon injury to the periodontal ligament , age, size of the pulp exposure , extent
of dentinexposed ,stageof root development.
55. Treatmentof crownfracture( complicated)
direct pulp capping
1)Pt seenwithin 1-2 hours
.
2)Toothvital +small
exposure +Sufficient
crown.
Steps:washing + caoH +
Restoration
Pulpotomy :allowstheapicalportion in immature permanent
tooth(openapex)tocontinuetodevelop(apexogenesis) .
1)Pulpexposureislarge .
2)small pulpexposurebuttheptdidnotseektreatmentuntil
severalhoursordays.
3)insufficientcrowntoholdatemporaryrestoration,
5) In cases of closed apex with pulp
exposure and root fracture..
shallow orpartial pulpotomy :inflammation isnotwidespread +
1to2mmofcoronal pulpremoved +irrgation +control hemorrhage +caoH2.
conventional pulpotomy :inflammation is widespread
All coronalpulp champer removed + irrgation +controlhemorrhage +caoH2
Pulpectomy
Non vital +openapex.( blunderbusscanalorfunnel-
shaped apex)Thelumenofrootcanal islargest at
apexandsmallest inthecervicalarea →
APEXIFICATION
Mature (closedapex)→
RCT
56. Conventional pulpotomy
After 20 months (Root completion)
8 months after initial treatment,
after the class IV crown fracture
59. (APEXIFICATION)
therapy to stimulate root growth and apical repair subsequent to pulpal necrosis in permanent
teeth.
Technique : isolated with a rubber Dam + access opening + instrumentation + irrigation +
drying ofthecanal +caoH2 &CMCP orcaoH2 inamethylcellulose paste+restoration .
the treatment paste is allowed to remain for 6 months → presence of a “positive stop” →
gutta-percha filling .
If apical closure has not occurred in 6 months, the root canal is retreated with the calcium
hydroxide paste.
62. A)Injuries tohard tissues andpulp.
4)Crown/rootfracture :
Definition:anenamel,dentin,andcementumfracturewithorwithoutpulpexposure.
Diagnosis: clinically → a mobile coronal fragment with or without a pulp exposure ,Radiographic → a radiolucent
obliquelinethatcomprisescrownandroot .
Treatment :
o • Primary teeth :the entire tooth should be removed when cannot be restored . unless retrieval of apical fragments may
resultindamageto thesuccedaneoustooth.
o •Permanentteeth:;
Theemergencytreatment →stabilizethecoronalfragment.
treatmentalternatives→removethecoronalfragment→asupragingivalrestorationor gingivectomy orextrusion.
Ifthepulpisexposed,→pulpcapping,pulpotomy,RCT.
Note:Fracturesextending belowthegingivalmarginmaynotberestorable.
63.
64. A)Injuries tohard tissues andpulp.
5)Rootfracture
Definition: a dentin and cementum fracture involving the pulp .could be vertical, oblique or
horizontal oratapical,middleorcoronal thirds..
Diagnosis:
o Clinically:amobile coronal fragmentthatmaybedisplaced.
o Radiographic :may reveal 1 or more radiolucent lines that separate the tooth fragments in horizontal
fractures.Multipleradiographicsatdifferentangulationsmayberequired .
Treatment :
o Primaryteeth: extraction ofcoronalfragmentwithout removing apicalfragmentand observation.
o Permanent teeth: Reposition and stabilize the coronal fragment . to optimize healing of the
periodontal ligamentandneurovascularsupply →Pulpnecrosis .
65. Rootfractures inpermanent teeth:
Apicalfractures:
Havebetterprognosis thanother typesof rootfracture.
ifthetooth hasbeendisplaced,(repositioned+rigidsplintfor2-3months) .R.C.T→
initiatedwhen clinicalandx-ray signsofnecrosis orresorption areapparent.
Middlethirdfractures:
immediate reduction + endodontic treatment + immobilization (a rigid splint for 2-3
months) . If the fragments are not maintained in position, inflammation occurs with
subsequent resorption .
66. Fractureofthecoronalthirdoftheroot
If the facture line is seen to extend more than 4 mm below the gingival attachment
in an oblique fracture, or is below the level of the alveolar crest in a transverse
fracture, thenthe rootshould beextracted.
A tooth with a short root, unsuitable for supporting a restoration, should also be
extracted.
If the fracture line-extends 1-2 mm. below the gingival margin → gingivectomy +
R.C.T+postandcore andpermanentfullcrown restorations.
71. 1)Concussion
Definition: injury to the tooth-supporting structures with-out abnormal loosening or
displacementofthetooth.
Diagnosis:
o a tooth tender to percussion without mobility, displacement, or sulcular bleeding and
Radiographicabnormalitiesarenot expected.
Treatment:
o primary teeth : unless associated infection exists, no pulpal therapy is indicated with minimal
riskforpulpnecrosis .
o maturepermanentteethwithclosed apices may→pulpalnecrosis →followed carefully.
72. 2)Subluxation
Definition: injury to tooth-supporting structures with abnormal loosening but without tooth
displacement , may or may not have sulcular bleeding. Radiographic abnormalities are not
expected.
Treatment:
Primaryteeth:→followedforpathology. shouldreturnto normalwithin2weeks.
Permanent teeth: Stabilization (flexible splint no more than 2 weeks. ) → relieve any occlusal
interferences.
permanent teeth (closed apices) may→pulpal necrosis→ followedcarefully.
73. 3 )Lateral luxation
Definition: displacement of the tooth in a direction other than axially. The periodontal ligament is torn and
contusion or fracture of the supporting alveolar bone occurs. The tooth usually is not mobile or tender to touch.
Radiographic →increase in PL space .
Treatment :
Primaryteeth : no occlusalinterference→ allow spontaneous reposition.
o occlusal interference → gently repositioned or slightly reduced if the interference is minor. ( increased risk of
developing pulp necrosis)
o Whenthe injury is severe orthe toothis nearing exfoliation→extraction .
Permanent teeth: reposition with digital pressure and little force then stabilize the tooth . may need to be
extruded to free itself from the apical lock in the cortical bone plate. Splinting an additional 2 to 4 weeks. In
permanent teeth ( closedapices) → pulp necrosisand pulp canal obliteration .
75. 4)Intrusion
Definition: apical displacement of tooth into socket, compressing the periodontal ligament and causes a crushing fracture of the
alveolar socket.thetooth appears tobeshortenedor,itmay appear missing.
Thetooth is notmobile ortendertotouch. Radiographic → PL space isnot continuous.
If the apex of tooth is displaced labially the tooth can be seen radiographically shorter than its contralateral. If is displaced palatally
thetoothappears elongated.
Treatment:
• Primary teeth: allow spontaneous reeruption except when displaced into the developing successor. Extraction is indicated. (90% of
intrudedteeth will reeruptspontaneously in2to6months).
incases ofcompleteintrusion Ankylosis may occur.
• Permanentteeth:
o immature teethwith moreeruptivepotential (root½to ²/³formed)→spontaneouseruption(repositionpassively ) .
o In mature teeth, reposition the tooth with orthodontic or surgical extrusion ( actively) → stabilization (splint for 3 to 4 weeks) . and
initiate endodontic treatment within the first 3 weeks of the traumatic incidence. there is considerable risk for pulp necrosis, pulp canal
obliteration, and progressiverootresorption.
86. REACTIONOFTHETOOTHTOTRAUMA
3)Calcific metamorphosis:(progressivecanalcalcificationordystrophiccalcification)
Is the condition where the pulp chamber and canal are gradually obliterated by progressive
depositionofdentin.
Thecrowns of teeth develop ayellowishopaque color.
Primaryteeth withcalcificmetamorphosis shownormalsheddingandrequirenotreatment.
Permanent teeth showing signs of calcific changes should be regarded as a potential focus of
infection.RCT shouldbestarted toprevent total canalobliteration.
88. REACTIONOFTHETOOTHTOTRAUMA
3) Pulpalnecrosis:
Occurs as a result of strangulation of apical vessels. It develops independent of
the severityofthe blow.
Root canal treatment of primary teeth is indicated if there is no extensive root
resorption orboneloss.
Permanentteethshould be treatedby routineendodontictherapy.
94. REACTIONOFTHETOOTHTOTRAUMA
6) Replacementresorption (ankylosis):
Results after severe injury to the periodontal ligament , with subsequent inflammation of
thefibersand invasionbyosteoclastic cells.
By time the roots are replaced with bone due to the normal physiologic osteoclastic and
osteoblastic activity.
Ankylosed anterior primary teeth which interfere with eruption of the successors →
extracted.
Permanentteeth areonlyremoved iftheadjacent teeththatcontinue toeruptdriftmesially
andcause alossofarchlength.
96. Reactionofpermanent toothbudstoinjury
Discoloration
Enamelhypoplasia ( Turnertooth)
Crown orrootdilacerations
Odontoma likemalformation
Development of reparative dentin to protect the pulp if the ameloblasts are
destroyedduring earlyenamelformation
Partialortotalinterruption ofrootformation
Ectopic eruption
97. Crown malformation following intrusion of
tooth 61 at the age of 2 years irregular root
formation of the neighbouring teeth, (a)
radiological and (b) postoperative findings.
98. (b) Circular enamel hypoplasia
following subluxation of the teeth 51,
61 and 62 at the age of 3.4 years.
(a) Enamel hypoplasia following
intrusion trauma at the age of 2.8
years.