Lateral Luxation

-displacement in axial direction

-torn PDL w/ contusion or fx of bone
-nontender and nonmobile
-txt: allow passive repositioning if possible, but if not then actively reposition and splint for 1-2 wks
-active repositioned tooth will more likely have necrosis than passively repositioned
Intrusion
-apical displacement into alveolar bone
-unless it is determined that the root of intruded primary tooth is impinging on permt successor, it is left alone in
hopes it will re-erupt on its own
-should be extracted if endangering permt tooth
-tooth should be x-rayed
Extrusion
-partial displacement of tooth out of socket axially
-the greater the distance from normal position, the greater chance of severing apical vasculature and pulpal necrosis
-tooth can be repositioned and splinted for 7-14 days
-endo txt should be done to prevent pulpal necrosis which can cause problems in permt tooth
Fractures
1) Enamel only: smooth enamel and check vitality at 1, 2, 6 months due to possibility of concussion
2) Enamel and dentin: smooth edges and restore; check vitality at 1, 2, 6 months
3) Enamel, dentin, and pulp:
a) vital pulp: pulpotomy
b) necrotic pulp w/o internal/external resorption: pulpectomy
c) Necrotic pulp w/ resorption: extraction
Avulsion
-replanting primary teeth has poor prognosis
-can be considered if within 30 minutes
-if replanted, splint, recommend soft diet, give antibiotics, and follow w/ pulpectomy
-antibiotics following replantation:
a) doxycycline
b) Pen VK (if susceptible to tetracycline staining in permt teeth)
-PRIMARY TEETH SHOULD NOT BE REPLANTED
Ellis Classification
1) Class I: involves little or no dentin
-enameloplasty or bonding
2) Class II: involves dentin but not pulp
-CaOH or GI
3) Class III: involves pulp
-pulp therapy and restoration
4) Class IV: loss of entire crown
-pulpectomy and SSC
5) Class V: teeth avulsed
6) Class VI: fracture of root w/ or w/o loss of crown
7) Class VII: displacement of tooth w/ or w/o loss of crown
8) Class VIII: fracture of crown en masse
9) Class IX: traumatic injuries to primary dentition