Managing Dental Injuries

 

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

Learning Objectives

After completing this course, you will be able to:

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.

L earning 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.

 

1. The Dental-Trauma Patient

History

General

Medical

Dental

Clinical Examination

Extraoral Examination

Oral Examination

Radiographic Examination

2. Injuries to Permanent Teeth

v Concussion and Subluxation

General Considerations

Treatment

v Crown Fractures

General Considerations

Enamel Fractures

Enamel and Dentin Fractures

Fractures Into the Pulp

v Root Fractures

General Considerations

Diagnosis

v Isolated-Root Fractures

v Crown-Root Fractures

Immediate Treatment

Isolated-Root Fractures

v Crown-Root Fractures

Definitive Treatment

Isolated-Root Fracture

v Crown-Root Fractures

3. Displacement of Permanent Teeth

v General Considerations

v Neurovascular Injury and Pulpal Necrosis

v Periodontal Ligament Injury and Resorption

Physiology of Tooth Injuries

v Splinting Methods

v Lateral Displacement (Luxation) of Permanent Teeth

History and Diagnosis

v Immediate Treatment

v Definitive Treatment

v Extrusion of Permanent Teeth

History and Diagnosis

Immediate Treatment

Definitive Treatment

v Intrusion of Permanent Teeth

History and Diagnosis

Immediate Treatment

Definitive Treatment

v Avulsion of Permanent Teeth

History and Diagnosis

Immediate Treatment

Definitive Treatment

4. Injuries to Primary Teeth

v General Considerations

v History and Clinical Examination

v Concussion and Subluxation

v    Crown Fractures

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

v    Displaced Primary Teeth

Lateral Displacement

Intrusion

Extrusion

Avulsion

Lacerations

5. Acute-Temporomandibular- Joint Injuries

v Temporomandibular-Joint Anatomy

v  Traumatic-Posterior Capsulitis

Diagnosis

Treatment

v  Anterior Disc Dislocation Without Reduction

Diagnosis

Treatment

v Sprained-Capsular Ligament

Diagnosis

Treatment

v Dislocation of the Mandible

Diagnosis

Treatment

6.  Soft-Tissue Lacerations

v Principles of Suturing

v Physiology of Wound Healing

v Suture Materials

Needles

Suture Material

Absorbable Sutures

Nonabsorbable Sutures

v Biological Response to Sutures

v Suturing Oral and Facial Lacerations

v General Considerations

v Tongue Lacerations

v Lip Lacerations

v "De-gloving" Lacerations

7. Alveolar Fractures

v General Considerations

v   History and Diagnosis

v Treatment

8. Mandible Fractures

v General Considerations

v Physiology of Bone Repair

v Causes of Mandible Fractures

v Classification of Mandible Fractures

v Diagnosis

History and Symptoms

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

v Clinical Findings

v Malocclusion

v Mobility of the Fracture Site

v Crepitus at the Fracture Site

v Abnormal Function of the Mandible

Radiographic Findings

v Diagnosis of Specific Fractures

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

v Treatment of Mandible Fractures

v Dental Care After a Mandible Fracture

9. Midface Fractures

v Fractures of the Maxilla

Le Fort I Fracture
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

v Dental First-Aid Kits

v Emergency Field Dentistry

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

 

 

 

 

 

 

 

 

 

 

 

 

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