Anterior tooth trauma in the primary dentition: Incidence, classification, treatment methods and sequelae: A review of the literature

Author(s): Irwin Fried, DDS, MS; Pamela Erickson, DDS, PhD
Journal: Journal of Dentistry for Children
Volume (number): 62: 256-61
Month, Year: 1995
Major topic: dental trauma in primary dentition
Minor topic(s): none
Type of Article: Literature review/review of clinical protocol
Main Purpose: to review primary tooth trauma, encompassing incidence, classification methods, treatment modalities, follow-up scheduling, and future sequalae
Overview of method of research: Literature Review
Findings: the occurrence of traumatic injury to primary dentition has an incidence of 4-30%; One study found that 17% of cases involved the maxillary central incisor. Younger patients incur most dental injuries due to coordination and judgment levels.
Key points/Summary: fractured primary teeth are classified in the same manner as permanent teeth, first listing the tooth injury (Ellis fracture classification) and then listing a subclassification of periodontal trauma, (concussion, subluxation, luxation). The following diagnostic steps should be taken when assessing oral trauma: medical hx, neurologic eval, clinical head and neck exam, oral examination (soft & hard tissues), radiographic examination, & photo documentation. Lacerations on facial skin should be treated by a plastic surgeon. Make sure you check for normal range of jaw movements. Use saline +/o gauze to rinse away any blood clots interfering with visualization of oral soft tissues. Fracture treatment: class I – do nothing, class II – resin +/o CaOH base, class III – pulpotomy/pulpectomy, any root fractures – extract. Periodontal trauma treatment: concussion – do nothing, subluxations – leave alone unless about to exfoliate, then extract, leave intrusive luxation to reerupt unless it is impinging on permanent tooth bud, & alveolar fractures – splint for 7-10 days. Follow up schedule: 7-10 days, 3 weeks, 3 months, 6 months. At follow ups perform following: percussion, palpation, and evaluation of color change. Do not base extraction on color change. Evaluate ankylosis by dull thud/metallic sound and submergence of tooth.
Assessment of article: this is a good overview/review. It is yet another article that reinforces our need for radiographic imaging when on call at HASBRO