Difference between revisions of "Dental subluxation"
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| + | ==Background== | ||
| + | |||
| + | |||
| + | ==Clinical Features== | ||
| + | [[File:PMC5149104 jced-8-e634-g001.png|thumb|Coronal incisor fractures and with extrusive luxation of the upper right central incisor.]] | ||
| + | *Tooth is mobile but is still in original anatomic position | ||
| + | *If multiple consecutive teeth are involved, rule out underlying alveolar ridge fracture or other [[Mandible fracture]] | ||
| + | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Template:Dental Problems DDX}} | {{Template:Dental Problems DDX}} | ||
| − | == | + | ==Evaluation== |
| − | + | *Clinical diagnosis | |
| − | |||
| − | |||
| − | == | + | ==Management== |
| − | + | ===Extrusive Luxation=== | |
| − | + | *(tooth is moved partially out of the socket) | |
| − | + | *Reposition tooth | |
| − | + | *Follow up within 24hr for stabilization | |
| − | + | *Temporizing measure: Periodontal pack (e.g.-Coe-Pak) in which tooth is bonded to its two neighboring teeth on both sides | |
| − | + | **Mix the resin and catalyst paste and apply to completely dry teeth | |
| + | **May use nasal cannula with oxygen as a air/drying source | ||
| + | **May place gauze rolls in mucobuccal fold to absorb saliva | ||
| + | **Wet or lubricated goves will allow for easier handling | ||
| + | **Apply splinting to the facial side of the teeth, spanning approximately 1-2 teeth in either direction | ||
| + | **Avoid covering the occlusal (biting) surface | ||
| − | ==Intrusive Luxation== | + | ===Lateral Luxation=== |
| − | + | *(tooth displaced in a direction other than inward or outward) | |
| − | + | *More extensive injury than extrusive luxation | |
| − | + | **Associated with cracking or fracture of the surrounding alveolar bone | |
| + | *Attempt repositioning of tooth | ||
| + | *Apply temporary splinting with periodontal dressing | ||
| + | *Follow up within 24hr for stabilization | ||
| + | |||
| + | ===Intrusive Luxation=== | ||
| + | * (tooth is forced inward into the socket) | ||
| + | *Most serious because of significant damage to alveolar socket and periodontal ligament | ||
| + | *Allow tooth to erupt on its own | ||
| + | |||
| + | ==Disposition== | ||
| + | *Discharge with dental follow up | ||
==See Also== | ==See Also== | ||
| Line 25: | Line 47: | ||
==References== | ==References== | ||
<references/> | <references/> | ||
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| − | |||
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[[Category:ENT]] | [[Category:ENT]] | ||
[[Category:Trauma]] | [[Category:Trauma]] | ||
Latest revision as of 20:25, 22 October 2019
Contents
Background
Clinical Features
- Tooth is mobile but is still in original anatomic position
- If multiple consecutive teeth are involved, rule out underlying alveolar ridge fracture or other Mandible fracture
Differential Diagnosis
Dentoalveolar Injuries
Odontogenic Infections
- Acute alveolar osteitis
- Acute necrotizing ulcerative gingivitis (trench mouth)
- Dental caries (pulpitis)
- Ludwig's angina
- Periapical abscess
- Pericoronitis
- Periodontal abscess
- Peritonsillar abscess (PTA)
- Retropharyngeal abscess
- Vincent's angina - tonsillitis and pharyngitis
Other
Evaluation
- Clinical diagnosis
Management
Extrusive Luxation
- (tooth is moved partially out of the socket)
- Reposition tooth
- Follow up within 24hr for stabilization
- Temporizing measure: Periodontal pack (e.g.-Coe-Pak) in which tooth is bonded to its two neighboring teeth on both sides
- Mix the resin and catalyst paste and apply to completely dry teeth
- May use nasal cannula with oxygen as a air/drying source
- May place gauze rolls in mucobuccal fold to absorb saliva
- Wet or lubricated goves will allow for easier handling
- Apply splinting to the facial side of the teeth, spanning approximately 1-2 teeth in either direction
- Avoid covering the occlusal (biting) surface
Lateral Luxation
- (tooth displaced in a direction other than inward or outward)
- More extensive injury than extrusive luxation
- Associated with cracking or fracture of the surrounding alveolar bone
- Attempt repositioning of tooth
- Apply temporary splinting with periodontal dressing
- Follow up within 24hr for stabilization
Intrusive Luxation
- (tooth is forced inward into the socket)
- Most serious because of significant damage to alveolar socket and periodontal ligament
- Allow tooth to erupt on its own
Disposition
- Discharge with dental follow up