Managing Dental Injuries  

By Gary F. Arnet, D.D.S.

Course Contents

    1. The Dental-Trauma Patient

            History

            General

            Medical

            Dental

            Clinical Examination

            Extraoral Examination

            Oral Examination

            Radiographic Examination

    2. Injuries to Permanent Teeth

         Concussion and Subluxation

            General Considerations

            Treatment

        Crown Fractures

            General Considerations

            Enamel Fractures

          Enamel and Dentin Fractures

          Fractures Into the Pulp

        Root Fractures

            General Considerations

            Diagnosis

        Isolated-Root Fractures

        Crown-Root Fractures

            Immediate Treatment

      Isolated-Root Fractures

 Crown-Root Fractures

        Definitive Treatment

        Isolated-Root Fracture

Crown-Root Fractures

3. Displacement of Permanent Teeth

        General Considerations

        Neurovascular Injury and Pulpal Necrosis

        Periodontal Ligament Injury and Resorption

            Physiology of Tooth Injuries

 Splinting Methods

 Lateral Displacement (Luxation) of Permanent Teeth

            History and Diagnosis

 Immediate Treatment

 Definitive Treatment

 Extrusion of Permanent Teeth

            History and Diagnosis

            Immediate Treatment

            Definitive Treatment

     Intrusion of Permanent Teeth

            History and Diagnosis

            Immediate Treatment

            Definitive Treatment

     Avulsion of Permanent Teeth

            History and Diagnosis

            Immediate Treatment

            Definitive Treatment

4. Injuries to Primary Teeth

 General Considerations

 History and Clinical Examination

 Concussion and Subluxation

 Crown Fractures

            Enamel Fractures
            Enamel and Dentin Fractures
            Fractures into the Pulp
            Root Fractures

   Displaced Primary Teeth

            Lateral Displacement

       Intrusion

             Extrusion

            Avulsion

            Lacerations

5. Acute-Temporomandibular- Joint Injuries

     Temporomandibular-Joint Anatomy

 Traumatic-Posterior Capsulitis

            Diagnosis

            Treatment

  Anterior Disc Dislocation Without Reduction

            Diagnosis

            Treatment

 Sprained-Capsular Ligament

            Diagnosis

            Treatment

 Dislocation of the Mandible

        Diagnosis

        Treatment

6.  Soft-Tissue Lacerations

     Principles of Suturing

     Physiology of Wound Healing

     Suture Materials

            Needles

            Suture Material

            Absorbable Sutures

            Nonabsorbable Sutures

         Biological Response to Sutures

         Suturing Oral and Facial Lacerations

         General Considerations

         Tongue Lacerations

         Lip Lacerations   

         "De-gloving" Lacerations

7. Alveolar Fractures

     General Considerations

     History and Diagnosis

     Treatmentt

8. Mandible Fractures

         General Considerations

         Physiology of Bone Repair

         Causes of Mandible Fractures

         Classification of Mandible Fractures

         Diagnosis

            History and Symptoms

  Pain
            Tenderness
            Swelling
            Ecchymosis
            Trismus
            Abnormal Function
            Crepitus
            Malocclusion
            Anesthesia/Paresthesia
            Excessive Salivationn
            Fetor Ex Or

         Clinical Findings

         Malocclusion

         Mobility of the Fracture Site   

         Crepitus at the Fracture Site

         Abnormal Function of the Mandible

            Radiographic Findings

         Diagnosis of Specific Fractures

  Symphysis Fractures
            Parasymphysis Fractures
            Body Fracturess
            Angle Fractures
            Ramus Fractures
            Condyle and Subcondylar Fractures
            Coronoid Fractures
            Edentulous Mandibular Fractures

         Treatment of Mandible Fractures

         Dental Care After a Mandible Fracture

9. Midface Fractures

        Fractures of the Maxilla

            Le Fort I Fracturee
            Le Fort II Fracture
            Le Fort III Fractures

            Fractures of the Zygomatic Complex

            Fractures of the Zygomatic Arch

            Fractures of the Nasal Bones

10. Dental first Aid in the Field

         Dental First-Aid Kits

         Emergency Field Dentistry

            Proper Oral Hygienee
            Toothache (Pulpitis)
            Dental Abscess
            Lost Restorations
            Injuries to Teeth
            Facial Fractures

 

Learning Objectives

After completing this course, you will be able to:o:

1. The Dental-Trauma Patient

  1. Describe how to take a history and examine a patient with dental injuries.

  2. Indicate what radiographs are useful in evaluating the dental-trauma patient.

2. Injuries to Permanent Teeth

  1. Distinguish between different types of injuries to permanent teeth.

  2. Describe various types of crown fractures.

  3. Describe various types of root fractures, make a diagnosis and provide immediate and definitive treatment.

3. Displacement of Permanent Teeth

  1. Discuss the pathophysiology of injuries to the teeth.

  2. Provide treatment options for injuries to permanent teeth.

  3. Describe the advantages of semirigid and rigid splinting techniques.

  4. Explain how to monitor and treat pulpal complications of dental injuries.

  5. Discuss how to monitor and treat root resorption caused by dental injuries.

  6. Describe neurovascular injury and pulpal necrosis and periodontal ligament injury and resorption.

  7. Describe lateral displacement (luxation) of permanent teeth, make a diagnosis, and provide immediate and definitive treatment.

  8. Describe extrusion of permanent teeth, make a diagnosis, and provide immediate and definitive treatment.

  9. Describe intrusion of permanent teeth, make a diagnosis, and provide immediate and definitive treatment.

  10. Describe avulsion of permanent teeth, make a diagnosis, and provide immediate and definitive treatment.

4. Injuries to Primary Teeth

  1. Explain the diagnosis and treatment options for injuries to primary teeth.

  2. Describe concussion and subluxation of primary teeth, make a diagnosis and provide a treatment.

5. Acute-Temporomandibular-Joint Injuries

  1. Describe the anatomy of the temporomandibular joint.

  2. Differentiate between the four types of acute-temporomandibular-joint injuries.

  3. Provide a treatment plan for acute injuries of the temporomandibular joint.

  4. Make a diagnosis and provide treatment for traumatic-posterior capsulitis.

  5. Describe anterior-disc dislocation without reduction, make a diagnosis, and provide a treatment.

  6. Describe dislocation of the mandible, make a diagnosis, and provide a treatment.

6. Soft-Tissue Lacerations

  1. List the advantages of various types of suture materials used to treat lacerations.

  2. Describe the benefits and applications of absorbable and nonabsorbable sutures.

  3. Provide the rationale and steps for suturing oral and facial lacerations.

  4. Give an explanation of wound healing in soft-tissue lacerations.

7. Alveolar Fractures

  1. Explain the diagnosis and treatment of alveolar fractures.

  2. Take history, make a diagnosis, and provide treatment for alveolar fractures.

8. Mandible Fractures

  1. Discuss the physiology of bone repair.

  2. Identify various causes of mandible fractures.

  3. Provide a classification of mandible fractures, by location, type of fracture, severity of fracture, and the direction or displacement of fracture.

  4. Discuss the physiology of bone healing following a fracture of the mandible.

  5. Provide an explanation for the symptoms of mandible fractures.

  6. Differentiate between various types of mandible fractures.

  7. List symptoms of patients who have sustained fractures of the mandible.

  8. Make a diagnosis of specific fractures of the mandible.

  9. Provide treatment for mandible fractures.

9. Midface Fractures

  1. Describe three types of fractures of the maxilla, their diagnoses, and stabilization techniques for the patient.

  2. Describe the fractures of the zygomatic complex, zygomatic arch and nasal bones.

  3. List the clinical findings of fractures of the midface, zygoma, and nose.

10. Dental First Aid in the Field

  1. Discuss methods of dental first aid in field conditions.

  2. Give recommendations to patients about materials they should carry in a dental first- aid kit.

  3. List at least 9 items that should be included in the dental first-aid kit.

  4. Describe how certain dental emergencies in the field should be handled.

  5. State the importance of being prepared for dental injuries and emergencies in the field.

  6. Discuss emergency-field dentistry including proper oral hygiene, toothache, dental abscess, lost restorations, injuries to teeth and facial fractures.

Learning Objectives

To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.

 

 

 

 

 

 

 

 

 

 

 

 

 

- -