Oral and Dental Injuries

Traumatic dental injuries can be classified into soft tissue injuries, hard tissues injuries (e.g., fractures), and periodontal injuries (e.g., luxation).¹¹

Soft tissue injuries may present as abrasions, contusions, or lacerations on the extra-oral and intra-oral soft tissues, including the lips, oral mucosa, gingiva, and frenulum.

Hard tissue injuries are classified into fractures of tooth structure and alveolar bone as well as mandibular and maxillary fractures.

• Enamel Fractures are limited to the enamel only.

• Enamel-Dentin Fractures (uncomplicated crown fracture) affect the enamel and dentin without exposing the pulp.

• Crown Fracture with Exposed Pulp (complicated crown fracture) involve enamel and dentin, plus the pulp is exposed.

• Crown-Root Fractures affect the enamel, dentin, and root; the pulp may or may not be exposed.

• Root Fractures affect dentin, cementum, and pulp. They may occur in any direction or orientation and are generally classified as vertical or horizontal root fractures.

• Alveolar Fractures affect the alveolar bone (labial and palatal/lingual) and may extend to the adjacent bone.

Figure 1. Hard Tissue Injury (Enamel-Dentin Fracture)

Figure 1. Hard Tissue Injury (Enamel-Dentin Fracture)

Periodontal injuries involve the periodontal apparatus and include:

• Concussion : The tooth will be tender to touch, with normal mobility and no gingival bleeding.

• Subluxation : The tooth will show tenderness and increased mobility but no displacement.

• Extrusive Luxation : The partial displacement of the tooth out of its socket.

• Lateral Luxation : The displacement of the tooth in a palatal/lingual or labial direction

• Intrusive Luxation : The apical displacement of the tooth, usually through the labial bone plate.

• Avulsion : The complete loss of the tooth out of the socket.