sequelae of trauma

Complications of dental trauma …

Primary teeth• Failure to continued

eruption• Discoloration• Infection and abscess• Loss of space in dental

arch• Ankylosis• Injury to developing

permanent tooth• Abnormal exfoliation• Financial costs

Complications of dental trauma……..Permanent teeth• Color changes• Infection &

abscess• Loss of space • Loss of alveolar

bone support• Ankylosis• Resorption of

root• Abnormal root

development• Financial costs

Sequelae of trauma of primary teeth on permanent tooth

Andreasen 19811.White or yellow-brown discoloration of enamel -

hypomineralization2. White or yellow-brown discoloration of enamel

With circular enamel hypoplasia –hypomineralization combined with hypoplasia.

3.Dilacerations4.Odontoma-Like Malformation:5.Partial/complete arrest of root formation:6.Sequestration of Permanent Tooth Germs7.Disturbance in Eruption8.Dentoalveolar Ankylosis

1.

White or yellow-brown discoloration of enamel -

hypomineralization

• sharply demarcated, stained enamel opacities, most often located on the facial surface of the crown

• 23% following injuries to the primary dentition

• Incisals 1/3rd of central and lateral incisor

• Differential diagnosis:

1. patients operated for cerebral palsy show very high frequency of enamel defect in the primary as well as the permanent dentition.

2. Endotracheal Intubation in Neonates

1. Extraction of primary molars

2. periapical inflammation of the primary teeth-“Turner Tooth”

Treatment :

1.Enamel micro-abrasion.

2. Acid etch and tooth mousse in some of the cases.

3. Composite resin restoration:

4.Porcelain jacket crown; at a later age.

• The typical finding -narrow horizontal groove which circles the crown cervically

• Frequency reported is 12% following injury to the primary dentition; the maxillary central incisors

• Radiographic examination reveals a transverse radiolucent line at the level of indentation

• This type of developmental defect can be usually diagnosed before eruption.

White or yellow-brown discoloration of enamel With circular enamel hypoplasia

Dilaceration • It is an abrupt deviation in the long axis of the crown or root

of the tooth

• common sequence after trauma, especially after intrusion

• Maxillary incisors usually show lingual deviation, while lower incisors are usually inclined facially

• R/G: the unerupted crown or the dilacerted teeth are seen foreshortened.

TREATMENT

• 1.Surgical exposure (extrusion) and possibly orthodontic realignment.

• 2.Removal of the dilacerated part of the crown

• Temporary crown until root formation is completed

• 4. Semi- or permanent restoration

Odontoma-Like Malformation:

• maxillary incisors

• Histology and radiology- during the early phases of odontogenesis and affect the morphogenetic stages of the ameloblastic development

• TREATMENT:

Partial/complete arrest of root

formation:• 2% of the involved permanent teeth

• Directly affects HERS

• R/G: foreshortening of root & root resorption

• Treatment: surgical extraction

Sequestration of Permanent Tooth Germs:

• It’s very rare• swelling, suppuration, and fistula formation

(although the tooth has been avulsed or intruded or lost)

• Treatment: surgical removal of tooth

Disturbance in Eruption:• Abnormal changes in the connective tissue

overlying the tooth• Treatment: sometimes we need to do surgical

exposure in order for the tooth to erupt

Dentoalveolar Ankylosis:• Replacement resorption• It will cause the bone to stop growing in that area.