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Dento-alveolar fractures |
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Dento-alveolar fracture fragments are well worth repositioning into the correct occlusal relationship, often under local anaesthesia, and are then immobilized with an acrylic occlusal splint, which accurately fits the upper teeth. Alternative methods of immobilization are metal arch bars which are wired to the teeth, including the fracture segment, and cast silver splints which can be cemented or wired directly to the alveolar bone.
The fragment is immobilized for 4—6 weeks, after which time the dento-alveolar fracture has usually firmly united.
Clinical feature: ¨ Stepped alignment of teeth ¨ Derangement of occlusion ¨ Lacerations of gingival / mucosa ¨ Overlying bruising / haematoma of mucosa ¨ Mobile segment of teeth ¨ Palpable fracture in buccal sulcus ¨ Oedematous lips ¨ Ragged laceration of inner aspect of lips and cheek
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These injuries involve the teeth and their supporting bone— the alveolus. The fractured segment may be completely avulsed, or more usually is retained, and remains viable because of an attached mucoperiosteal vascular pedicle. |
