PAEDIATRIC DENTISTRY - 3rd Ed. (2005)

(John Hannent) #1

their development.


12.5.1 Uncomplicated crown fracture


Either smooth sharp edges or restore with an acid-etch restoration if co-operation is
satisfactory.


12.5.2 Complicated crown fracture


Normally, extraction is the treatment of choice. However, pulp extirpation and canal
obturation with zinc oxide cement, followed by an acid-etch restoration is possible
with reasonable co-operation.


12.5.3 Crown-root fracture


The pulp is usually exposed and any restorative treatment is very difficult. The tooth
is best extracted.


12.5.4 Root fracture


Without displacement and with only a small amount of mobility the tooth should be
kept under observation. If the coronal fragment becomes non-vital and symptomatic
then it should be removed. The apical portion usually remains vital and undergoes
normal resorption. Similarly with marked displacement and mobility only the coronal
portion should be removed.


12.5.5 Concussion, subluxation, and luxation injuries


Associated soft tissue damage should be cleaned by the parent twice daily with 0.2%
chlorhexidine solution using cotton buds or gauze swabs until it heals.


Concussion


Often not brought to a dentist until the tooth discolours.


Subluxation


If slight mobility then the parents are advised on a soft diet for 1-2 weeks and to keep
the traumatized area as clean as possible. Marked mobility requires extraction.


Extrusive luxation


Marked mobility requires extraction.


Lateral luxation


If the crown is displaced palatally the apex moves buccally and hence away from the
permanent tooth germ. If the occlusion is not gagged then conservative treatment to
await some spontaneous realignment is possible. If the crown is displaced buccally
then the apex will be displaced towards the permanent tooth bud and extraction is

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