Operative dentistry aje qualtrough, jd satterthwaite la morrow, pa brunton

80


Chapter 3
POOC03 02/18/2005 04:33PM Page 80

---

4
81
Endodontics – 
further considerations
TRAUMA
Injuries to teeth are common. In a prospective study where all dental
injuries occurring from birth to the age of 14 were registered, it 
was found that 30% of children had sustained injuries to the primary
dentition and 22% to the permanent dentition
1
. These statistics are
age-related. In the primary dentition, the prevalence of injuries ranges
from 31 to 40% in boys and from 16 to 30% in girls. In the permanent
dentition, the prevalence of dental trauma in boys ranges from 12 to
33% compared with 4 to 19% in girls. Most injuries affect the maxillary
incisors and in the majority of cases, only one tooth is affected. An
increased overjet with prominent incisors and incompetent lips have
been found to be predisposing factors.
Prevention
Patients with an increased maxillary overjet have a significantly
greater risk of traumatic dental injuries. An additional trauma factor
is insufficient lip protection. Collision sports have been the cause of
many injuries to the head and neck. It is clear that protection of the
oral and dental tissues is needed for all participants in active contact
sports. This is best provided by a gum shield made by a dentist.
Effects
Traumatic injuries may affect the teeth in various ways including:
• Chipped enamel or enamel infraction
• Fracture into dentine
POOC04 02/18/2005 04:35PM Page 81

---

• Fracture exposing pulp
• Fracture involving both crown and root
• Root fracture
• Avulsion
• Tooth loosened in socket (intrusion/extrusion/luxated)
History
This should include a medical and dental history, age, time of accident,
cause, pain, previous trauma history, loss of consciousness and treat-
ment already carried out for the injury including information about
the storage conditions of the tooth.