Traumatic dental injuries are common, attention-seeking problems that affect children worldwide. It is of utmost importance to treat such injuries correctly and on time to improve future outcomes and avoid pulpal and periodontal damage in cases of permanent tooth injury. It is as important to manage TDI in primary teeth to avoid disruptions to the succedaneous permanent teeth. Dental trauma falls under four main categories according to Andreasen (Feliciano and de França Caldas Jr, 2006); injuries to the hard tissues and dental pulp, injuries to the periodontium, injuries to the supporting alveolar bone, and injuries to the oral mucosa. Injuries to the Hard Tissues and Dental Pulp Uncomplicated Crown Fracture: this can include either an …show more content…
As an emergency treatment if the pulp is not involved, the fracture should be stabilized. Once the final treatment is decided upon, the options may range from removal of the fractured segment, removal of the fractured segment along with gingivectomy or osteotomy, removal of the fractured segment along with orthodontic extrusion, decoronation (if implant will be placed later in order to preserve alveolar bone, or extraction. These options will vary depending on the amount of fractured root and the clinical situation. If the pulp is involved, the pulp’s vitality should be preserved especially if the tooth has an open apex. The same treatment options are available as the previous situation, however, pulp therapy must be performed. Follow up should be done to monitor the tooth. Root Fracture: this involves a fracture of the tooth across the root through the cementum, dentin and pulp. The fracture can be either in the cervical, middle, or apical third of the …show more content…
The correct repositioning of the segment should be confirmed along with the location of the fracture line radiographically. If the fracture line is in the apical or middle thirds of the root, a flexible splint should be placed for 4 weeks. If the fracture line is at the coronal third, a flexible splint should be placed for up to 4 months. There should be follow up for the tooth in order to monitor the vitality of the pulp at 6-8 months and then yearly. If there is necrosis of the pulp, then root canal treatment should be done for the coronal