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DENTISTERY
SEQUELAE OF TRAUMATIC
INJURIES TO PRIMARY TEETH
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INTRODUCTION
Complications following traumatic injuries
to primary teeth may appear shortly after
injury or after several months.
Most injury are prone in 2 to 4 years of
life when children learn to walk, play etc.
Any injury to teeth of young child can
have serious and long term consequences.
Most damaging sequelae of injuries to
primary teeth are their effect on
unerrupted developing permanent
dentition.
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SEQUELAE OF TRAUMA TO
PRIMARY TEETH
Reversible pulpits
Infection in periodontal ligament
Irreversible pulpitis
Pulp necrosis
Pulpal obliteration
Inflammatory resorption
Ankylosis
Coronal discolouration
Complication following intrusion
Complication following avulsion
Injuries to developing permanent dentition.
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REVERSIBLE PULPITIS
Initial response of pulp to trauma –
pulpitis
Teeth – Tender on percussion
- PDL is inflammed
May progress to an irreversible state
with necrosis of the pulp.
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INFECTION IN PERIODONTAL
LIGAMENT
Detachment of gingival fibers from tooth in the injury.
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Thus, if infection of PDL is their –
tooth should extracted
Chronic
Partial
Total
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Acute:- Painful if the exudate accompaning the
pulpal inflammation can not vent.
Chronic:- Inflammatory exudates are
quickly vented.
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PULP NECROSIS
Commonest complication.
Two mechanism explains how pulp of
injured teeth become necrotic.
Infection of pulp in cases of untreated
crown fracture with pulp exposure.
Interrupted blood supply to the pulp
leading to ischemia.
Untreated teeth with exposed pulps
expected to develop swellings of fistula.
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Loss of pulp vitality in early stage of
root development.
Arrest in dentin appostion & cessation
of root development.
Teeth with periapical inflammation
- Should be extracted
- To prevent possible damage to
successor.
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PULP OBLITERATION
Result of intensified activity of
odontoblasts
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INFLAMMATORY RESORPTION
Inflammatory Resorption
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INTERNAL RESORPTION
Inflammation of pulp
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EXTERNAL RESORPTION
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External surface root resorption
Characterized by- Gradual elimination of
root
dentin with preservation of PDL
Affects the apex of the root only and
becomes rounded & progress until the
natural exfoliation or traumatic avulsion
occurs.
As resorption progress:-
Bone replaces the space previously
occupied by the root
- Separates the primary tooth & its
permanent successor.
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In such cases –
Root resorption may be associated with
Expansion of permanent tooth follicle
Dilated follicle
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ANKYLOSIS
K/a Replacement resorption
Results after irreversible injury to PDL.
Ankylosed primary teeth.
May cause delay in or ectopic
eruption of developing permanent
tooth.
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CORONAL DISCOLOURATION
Results from changes in pulp- dentin
complex.
Variety of discolouration is divided
into three groups.
1. Pink – Red – Due to intra – pulpal
haemorrhage
2. Yellow- Due to pulpal obliteratation
3. Dark (Grey, Brown, Black):-
Due to pulp necrosis & haemorrhage
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Discolouration with
healthy buccal mucosa
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Injuries to developing teeth
are as follows:-
White or yellow- brown discolouration
of enamel.
White or yellow – Brown discolouration
of enamel with – Circular Enamel
Hypoplasia.
Crown dilaceration
Odontoma – like malformation
Root duplicator
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Vestibular or lateral root angulations &
dilacerations.
Partial or complete arrest of root formation.
Sequestration of permanent tooth germs
a) Disturbances in cruption
- Ectopic Eruption
- Delayed Eruption
Alteration in path of developing tooth crown.
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ABBERENT ERRUPTION WITH ITS INCISAL
EDGE HIGH IN THE LABIAL SULCUS
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REFERENCES
Pediatric Dentistry INFANCY Through
ADOLSENCE- PINKHAM
Pediatric Dentistry- WELBERY
Pediatric Dentistry-SHOBA TANDON
Mc Donald RE, Avery DR, Dean JA-Dentistry for child
and adolescent
Oral and dental trauma in children and adolescents-
GRAHAM,ROBERTS,PETER LONGHURST
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