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Dental Trauma to Periodontal Tissues


Dental Trauma to Periodontal Tissues

DescriptionClinical statusTreatment – permanent toothDeciduous tooth


Injury to tooth supporting structures with no displacement of toothVisually no displacement of tooth, TTP, no mobility, usually a positive vitality test and no abnormalities radiographicallyNo immediate treatment required. Monitor pulpal condition for a yearSame treatment as permanent teeth


Injury to tooth supporting structures with loosening of the tooth however with no displacementTender to percussion and increased mobility but no displacement of tooth as injury limited to the tooth supporting structures. Bleeding at gingival creviceNo immediate treatment required. Monitor pulpal condition for a yearSame treatment as permanent teeth


Loosening and partial displacement of the tooth out of its socket. Alveolar bone is still intact however may result in a partial or total separation of periodontal ligamentTooth appears elongated, TTP, excessively mobile, vitality testing inconclusiveReposition tooth back into tooth socket after surface has been cleaned with saline. Splint is applied and to be monitored after two weeks for further treatment. Root canal treatment where signs of pulpal necrosisExtract tooth. If minimal extrusion then leave and monitor

Lateral Luxation

Displacement of tooth in a lateral position – labially, lingually, distally or mesially. Most seen case is crown towards the palate with the apex going labially. Sensitivity to touch is present as well as sulcular bleedingTooth displaced usually at a palatal/ lingual or labial direction, sensitive to touch, sulcular bleeding, tooth locked into bone. Radiographically the tooth shows a widened periodontal ligament spaceTooth is repositioned into its original location and is splinted for 4 weeksIf crown displaced towards the palate and is not in traumatic occlusion then no treatment is required as apex of the tooth is away from the developing tooth germ. If apex of tooth is displaced towards the palate and making contact with the tooth germ then tooth is extracted

Intrusive Luxation

Displacement of tooth into the alveolar bone (pushed into the socket) causing fracture of the alveolar bone. It is the most damaging injury to the tooth and supporting tissues as ankylosis and pulp necrosis can occur. In severe cases, 100% of the crown is not visibleTooth displaced axially into alveolar bone, no mobility, negative to vitality testing. Periodontal ligament space may be absent radiographicallyDepending on severity of displacement, tooth may be left to allow for spontaneous eruption. If severe then orthodontic reposition or surgical repositioning is needed. Root canal treatment after 12 weeksTooth is extracted if apex of the root is in the developing tooth bud


Tooth is completely displaced out of the socket. Desiccation of periodontal ligament can not occure, as well as pulpal necrosis if no immediate action is taken placeTooth is absent from socketDepends on the maturity of the tooth, how the tooth was stored and patient cooperation. If tooth has been kept in favourable conditions and periodontal ligament is not necrotic, then tooth is replantedTooth is not replanted to avoid damage to developing tooth germ