Dental subluxation: Difference between revisions

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==Background==
==Background==
 
[[File:Enamel.png|thumb|Diagram of the tooth displaying the enamel, dentin, and pulp]]
{{Dental numbers}}


==Clinical Features==
==Clinical Features==
[[File:PMC5149104 jced-8-e634-g001.png|thumb|Coronal incisor fractures and with extrusive luxation of the upper right central incisor.]]
[[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
*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]]
*If multiple consecutive teeth are involved, rule out underlying alveolar ridge fracture or other [[mandible fracture]]


==Differential Diagnosis==
==Differential Diagnosis==

Latest revision as of 21:00, 2 December 2021

Background

Diagram of the tooth displaying the enamel, dentin, and pulp

Dental Numbering

Classic dental numbering.
  • Adult (permanent) teeth identified by numbers
    • From the midline to the back of the mouth on each side, there is a central incisor, a lateral incisor, a canine, two premolars (bicuspids), and three molars
  • Children (non-permanent) teeth identified by letters
  • Common landmarks:
    • 1: Right upper wisdom
    • 8 & 9: Upper incisors
    • 16: Left upper wisdom
    • 17: Left lower wisdom
    • 24 & 25: Lower incisors
    • 32: Right lower wisdom

Clinical Features

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

Dentoalveolar Injuries

Odontogenic Infections

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

See Also

References