I.

Answer the following questions:

Dental intrusion

1. What is dental intrusion?

It is an injury that displaces the tooth into the alveolar bone
2. What can percussion reveal?
It will reveal a high metallic or akylosed sound
3. Is the tooth mobile?
It is not mobile
4. What does pulp sensibility testing reveal?
Pulp will respond negative
5. What can X-ray reveal?
pdl space will be absent and the tooth will appear more apical to the adjiacent teeth
6. Why is X-ray necessary?
To see the position the the tooth
If the teeth 8 and 9 are displaced into the nasal cavity
7. What are treatment options?
- Spontaneous eruption
- Orthodontic repositioning
- Surgical repositioning, after applying flexible splint for 4 weeks
8. What does spontaneous eruption involve?
Spontaneous eruption is best for permanent teeth that have
incomplete root formation with a minor or moderate intrusion. In teeth with mature
root development, it is only recommended for teeth with a minor intrusion.
9. What is orthodontic repositioning?
This treatment is a good choice for patients who are
receiving delayed treatment. It does help to repair marginal bone with slow
repositioning of the tooth. This procedure should be initiated within the first three
weeks.
10. What is surgical repositioning?
This option is best for the acute phase of treatment. If the
intrusion resulted in the major dislocation of the tooth (more than 7 mm), this is a
good
option. This treatment should be initiated within the first three weeks.
11. What are patients’ recommendations?
1. Soft diet for one week.
2. Have good oral hygiene, brush 2 x/day.
3. Rinse with chlorhexidine 0.1% mouthwash 2x/day for one week.
4. Come to follow up appointments to remove the splint and check healing progress.
12. What is the follow up?
Follow up after two weeks.
2. Remove splint at four weeks (if indicated).
3. Follow up clinical and radiographic examinations at four weeks, 6-8 weeks, six months,
one year, and yearly for five years
1. What is dental extrusion?
 When the tooth is partially displaced out of the socket , with partial or total
separation of the pdl, and no fracture of the alveolar wall. The tooth itself will most
likely have a slightly protruded or retruded position.
2. Is the tooth position?
Will be a slight buccal or lingual position
3. What does pulp sensibility testing reveal?
A negative respond , or a lack of response that indicate a pulpal necrosis
4. What can X-ray reveal?
Reveal A widening of the pdl space
5. Why is X-ray necessary?
To see the tooth condition , the integrity of pdl , is also helpful to take a lateral view
from the mesial or distal aspect of the tooth in question. and to verify after the
treatment the final position
6. What is the treatment option?
. Clean the area with water, saline, or chlorhexidine.
2. Apply local anesthesia if necessary.
3. Reposition tooth by gently re-inserting it into the socket with axial digital pressure.
4. Verify the correct positioning with a radiograph.
5. Apply flexible splint for two weeks (up to 0.016” or 0.4mm).
7. Why should the pulpal condition be monitored?
To see if the pulp revascularized , to prevent future complications such as inflammatory
root resorption
8. What are patients’ recommendations?
1. Soft diet for one week.
2. Have good oral hygiene, brush 2 x/day.
3. Rinse with chlorhexidine 0.1% mouthwash 2x/day for one week.
4. Come to follow up appointments to remove the splint and check healing progress.
9. What is the follow up?
1. Follow up clinical and radiographic examinations and splint removal after two
weeks.
2. Follow up clinical and radiographic examinations at four weeks, 6-8 weeks, six
months,
one year and yearly for five years. For normal pulp responses, no further treatment
indicated.

Dental avulsion
1. What is dental avulsion?
Is the missing of a tooth or possible multiple teeth,
2. What does pulp sensibility testing reveal?
Pulp sensibility testing is not indicated for this injury
But cold test for the teeth in the area of the injury
3. What can X-ray reveal?
A radiograph is taken to rule out possible intrusive injury or root fracture
 Sometime intruded teeth looks like intruded but it is avulsed
To see If the apex of the avulsed teeth is open or close
4. Why is X-ray necessary?
To rule out any other types of injuries
5. What is the treatment option?
Depends on what you have discovered in your diagnosis
Reimplantation of the tooth immedistely
6. What should be done immediately after the injury has occurred?
1. to make sure if the is tooth is avulsed , if the tooth is permanent , because primary teeth
should not be re-implanted
2 . to not touch the root of the pulp
3.to wash the tooth briefly under cold water
4. to storage the tooth in a storage medium such as milk or saline , hank/s balance storage
solution
The tooth can be transported in the mouth between the teeth and the cheek, and never be
stored in water
7. What should be done after replanting the tooth ?
Should be applied a flexible splint for two weeks , administering systemic antibiotics
for seven days , to check if the tetanus buster is up to date.
If the tooth has a dry time longer than 60 minutes or closed apes , flexible splint is
for 4 weeks , systemic antibiotic for 7 days, and root canal therapy within 7 to 10
days after reimplantation.