ORAL MAXILOFACIAL AND SURGERY

TYPE & PREVELANCE OF DENTOALVEOLAR TRAUMA

Traumatic injuries to the dentoalveolar structures are relatively common and occur from various causes such as motor vehicle and bicycle accident,assaults,falls,sports,industrial accidents.

The reported prevelance of dentoalveolar injuries varies widely,depending on factors such as the age of the studied group,the cause of injury and gender. For example, dentoalveolar injury among pediatric patients is reported to account for 5% of all facial fractures. Among adolescents with sport related trauma,the incidence of dentoalveolar injuries is reported to be 36%. Overall,the prevelance of dentoalveolar injuries among children with primary dentition is 11%-30% and among children with permanent dentition it is 5%-20%. Boys are affected almost twice as often as girls, with a peak incidence at 2 to 4 years and 8 to 10 years.


Dentoalveolar Fractures can be divided into three group:

1) Injuries to Hard Dental Tissues and Pulp
2) Injuries to the Periodental tissues
3) Injuries to Supporting Bone



Injuries to Hard Dental Tissues and Pulp

1) Crown Infraction - A crown infraction is an incomplete fracture or crack of the enamel without loss of tooth substance
2) Uncomplicated Crown Fracture – Fracture confined to the enamel or involving the enamel and dentin without exposing the pulp
3) Complicated Crown Fracture – Fracture involves enamel and dentin with exposure of the pulp
4) Uncomplicated Crown-root Fracture – Fracture involves enamel,dentin,and cementum without exposure of the pulp
5) Complicated Crown-root Fracture – Fracture involves enamel, dentin, and cementum with exposure of the pulp
6) Root Fracture –Fracture involves dentin,cementum and the pulp


Injuries to the Periodontal Tissues

1) Concussion – An injury to the tooth supporting structures without abnormal loosening or displacement of the tooth, but with marked reaction to percussion
2) Subluxation – An injury to the tooth-supporting structures with abnormal loosening but without displacement of the tooth.
3) Intrusive Luxation – Displacement of the tooth into the alveolar bone with comminution or fracture of the alveolar socket
4) Extrusive Luxation – Partial Displacement of the tooth out of the alveolar socket
5) Lateral Luxation – Displacement of the tooth in a direction other than axially, accompanied by a comminution or fracture of the alveolar socket
6) Retained Root – Fracture with retention of the root segment , but loss of the crown segment out of the socket
7) Exarticulation – Complete Displacement of a tooth out of the alveolar socket


Injuries to Supporting Bone

1) Comminution of the Alveolar Socket – Crushing and comminution of the alveolar socket occur, together with intrusive and lateral luxation
2) Fracture Of the Alveolar Socket wall – Confined to the facial or lingual socket wall
3) Fracture of the alveolar process – A fracture of the alveolar process may or may not involve the alveolar socket
4) Fracture of the Mandible or maxilla – A fracture involving the base of the mandible or maxilla and often the alveolar process may or may not involve the alveolar socket