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.]] | |||
*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== | ||
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==Evaluation== | ==Evaluation== | ||
*Clinical diagnosis | |||
==Management== | ==Management== | ||
===Extrusive Luxation=== | ===Extrusive Luxation=== | ||
*(tooth is moved partially out of the socket) | |||
*Reposition tooth | *Reposition tooth | ||
*Follow up within 24hr for stabilization | *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 | *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=== | ===Lateral Luxation=== | ||
*(tooth displaced in a direction other than inward or outward) | |||
*More extensive injury than extrusive luxation | *More extensive injury than extrusive luxation | ||
**Associated with cracking or fracture of the surrounding alveolar bone | **Associated with cracking or fracture of the surrounding alveolar bone | ||
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===Intrusive Luxation=== | ===Intrusive Luxation=== | ||
* (tooth is forced inward into the socket) | |||
*Most serious because of significant damage to alveolar socket and periodontal ligament | *Most serious because of significant damage to alveolar socket and periodontal ligament | ||
*Allow tooth to erupt on its own | *Allow tooth to erupt on its own | ||
==Disposition== | ==Disposition== | ||
*Discharge with dental follow up | |||
==See Also== | ==See Also== | ||
Latest revision as of 21:00, 2 December 2021
Background
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
- 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 (dry socket)
- Acute necrotizing ulcerative gingivitis (trench mouth)
- Dental abscess
- Periapical abscess
- Periodontal abscess
- Ludwig's angina
- Pulpitis (dental caries)
- Pericoronitis
- 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