Uncomplicated Crown Fracture Primary tooth Smooth sharp edges Followup 1 wk 4 wk 68 wk 3 mo 4 mo 6 mo 1 yr Yearly Enamel fracture No F U recommended Enameldentin fracture ID: 929864
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Slide1
Enamel fracture
Enamel-Dentine facture
Uncomplicated Crown Fracture
Primary tooth
Smooth
sharp edges
Follow-up1 wk4 wk6-8 wk3 mo4 mo6 mo1 yrYearly Enamel fractureNo F/U recommended Enamel-dentin fractureC
Cover dentine exposure with GI / Composite resin
No radiograph recommended
Radiograph optional(1 Periapical film size 0 or Occlusal film size 2)
Mobility, DiscolorationTenderness to manual pressure
Mobility, DiscolorationTenderness to manual pressure
Parent / Patient Education
Eating care, avoid further trauma
Clean the affected area with soft brush
/ Cotton swab with 0.1-0.2 % Chlorhexidine mouthwash (2 times / day for 1 week)
C= Clinical review appointment
Slide2Complicated crown fracture
Complicated Crown Fracture
Primary tooth
1 Periapical film size 0 or Occlusal film size 2
+
Soft tissue radiograph
Mobility, DiscolorationTenderness to manual pressureLarge pulp exposurePartial pulpotomy withCa(OH)2 or Biodentine + RestorationSmall pulp exposureCervical pulpotomy withCa(OH)2 or Biodentine + RestorationFollow-up1 wk4 wk6-8 wk3 mo4 mo6 mo1 yrYearly Complicated crown fracture
C
C
C+R
Local anesthesia
Local anesthesia
Parent/ Patient Education
Eating care, avoid further trauma
Clean the affected area with soft brush
/
Cotton swab with 0.1-0.2 % Chlorhexidine mouthwash
(2 times
/
day for 1 week)
C = Clinical review appointment R = Radiographic advised
Slide3Crown-root fracture
Fracture
Primary tooth
Remove loose fragment
Restorable
Unrestorable
No pulp exposedCover dentine with GIPulp exposedPulpotomy / Pulpectomy(Depend on stage of root development)Crown-Root Fracture1 Periapical film size 0 or Occlusal film size 2Mobility, DiscolorationTenderness to manual pressureLocal anesthesiaExtract loose fragment and leave any firm rootFollow-up1 wk4 wk6-8 wk3 mo4 mo6 mo
1 yrYearly
Crown-Root fracture
C
C
C+R
Parent / Patient Education
Eating care, avoid further trauma
Clean the affected area with soft brush
/
Cotton swab with 0.1-0.2 % Chlorhexidine mouthwash
(2 times
/
day for 1 week)
C = Clinical review appointment R = Radiographic advised
Slide4Root fracture
Fracture
Primary tooth
Coronal segment is displaced.
Follow-up
1
wk4 wk8 wk1 yrYearlyCC + SC C C*Excessively mobile & Occlusal interferenceNot excessively mobileExtract coronal fragmentLeave apical fragmentReposition coronal fragmentIf unstable Splint 4 weeksCoronal segment is not displaced.No treatmentLeave spontaneous repositionEven if there is some occlusal interference. Follow-up
1 yr
Yearly
C
C*C* = Clinical follow-up yearly until eruption of permanent teeth
Follow-up
1
wk
6-8
wk1
yr
Yearly
C
C
C
C*
Root
Fracture
Mobility, Discoloration
Tenderness to manual pressure
Local anesthesia
1 Periapical film size 0 or Occlusal film size 2
Parent / Patient Education
Eating care, avoid further trauma
Clean the affected area with soft brush
/
Cotton swab with 0.1-0.2 % Chlorhexidine mouthwash
(2 times
/
day for 1 week)
C = Clinical review appointment
S
= Splint removal
Slide5Alveolar fracture
Reposition and Splint 4 weeks
C** = Further follow-up at 6 years old: monitor eruption of permanent teeth)
Follow-up
1
wk
4 wk8 wk3 mo4 mo6 mo1 yrYearly6 yrAlveolar fractureCC+R+SC C +RC**Alveolar FracturePrimary toothMobility, DiscolorationTenderness to manual pressure
Local anesthesia
1 Periapical film size 0 or Occlusal film size 2
Monitor eruption of permanent teeth at 6 years of age (C**)A lateral radiograph may give information about the relationship between the maxillary and mandibular dentitions
and if the segment is displaced in a labial directionIf Parent / Patient Education
Eating care, avoid further traumaClean the affected area with soft brush / Cotton swab with 0.1-0.2 % Chlorhexidine mouthwash (2 times / day for 1 week)
C = Clinical review appointment R = Radiographic advised S
= Splint removal
Slide6Concussion
Subluxation
Concussion & Subluxation
Primary tooth
Observe
Follow-up
1 wk4 wk6-8 wk3 mo4 mo6 mo1 yrYearly ConcussionCCSubluxationCC
C*
Observe
C*= Clinical follow-up yearly until eruption of permanent teeth
Mobility, Discoloration
Tenderness to manual pressure
Mobility, Discoloration
Tenderness to manual pressure
No radiograph recommended
1 Periapical film size 0 or Occlusal film size 2
Parent / Patient Education
Eating care, avoid further trauma
Clean the affected area with soft brush
/
Cotton swab with 0.1-0.2 % Chlorhexidine mouthwash
(2 times
/
day for 1 week)
C = Clinical review appointment
Slide7Extrusive luxation
Follow-up
1
wk
4
wk
6-8 wk3 mo4 mo6 mo1 yrYearlyExtrusionCC C C*Extrusive LuxationNot interfere occlusionExcessively mobile / Extrude > 3 mm.Leave spontaneous reposition Extraction Primary tooth
1 Periapical film size 0 or Occlusal film size 2
Mobility, DiscolorationTenderness to manual pressure
Local anesthesia
C*= Clinical follow-up yearly until eruption of permanent teeth
Parent / Patient Education Eating care, avoid further traumaClean the affected area with soft brush / Cotton swab with 0.1-0.2 % Chlorhexidine mouthwash (2 times
/ day for 1 week)
C = Clinical review appointment
Slide8Lateral luxation
Follow-up
1
wk
4
wk
8 wk3 mo4 mo6 mo1 yrYearlyLateral luxationCC+SC CC C*Lateral luxationMinimal / No occlusal interferenceSevere displacementAllows spontaneous reposition (usually 6 months)Extraction
Reposition &Splint for 4 weeks
Primary tooth
1 Periapical film size 0 or Occlusal film size 2Mobility, DiscolorationTenderness to manual pressure
C*= Clinical follow-up yearly until eruption of permanent teeth
Local anesthesia
Parent/ Patient Education
Eating care, avoid further trauma
Clean the affected area with soft brush
/ Cotton swab with 0.1-0.2 % Chlorhexidine mouthwash (2 times /
day for 1 week)
C = Clinical review appointment
S
= Splint removal
Slide9Intrusive luxation
Follow-up
1
wk
4
wk
6-8 wk3 mo4 mo6 mo1 yrYearly6 yrIntrusionCC CCC**AvulsionC
C**
Intrusive Luxation & Avulsion
Primary tooth
Allow spontaneous reposition
(usually 6-12 months)
Avulsion
No replantation
C= Clinical review appointment
C**= Further follow-up at 6 years old: monitor eruption of permanent teeth
For severe intrusion
,
monitor eruption of permanent teeth at 6 years old (C**)
1 Periapical film size 0 or Occlusal film size 2
Mobility, Discoloration
Tenderness to manual pressure
1 Periapical film size 0
or Occlusal film size 2
Monitor eruption of permanent teeth at 6 years old (C**)
Parent / Patient Education
Eating care, avoid further trauma
Clean the affected area with soft brush
/
Cotton swab with 0.1-0.2 % Chlorhexidine mouthwash
(2 times
/
day for 1 week)