Lateral luxation - Treatment Guidelines
To reposition and splint a displaced tooth to facilitate pulp and periodontal ligament healing.
- Rinse the exposed part of the root surface with saline before repositioning.
- Apply a local anesthesia
- Reposition the tooth with forceps or with digital pressure to disengage it from its bony lock and gently reposition it into its original location.
- Stabilize the tooth for 4 weeks using a flexible splint. 4 weeks is indicated due to the associated bone fracture.
Monitoring the pulpal condition is essential to diagnose root resorption. If the pulp becomes necrotic, root canal treatment is indicated to prevent
infection related root resorption.
In immature developing teeth, revascularization can be confirmed radiographically by evidence of continued root formation, initiation of pulp canal obliteration and usually a return to a positive response to sensibility testing.
In fully formed teIn fully formed
teeth, a continued lack of response to sensibility testing (i.e. exceeding 3 months) should be taken as evidence of pulp necrosis together with periapical
radiolucency and sometimes crown discoloration.
Splint removal: after the fixation period (4 weeks) resin can be removed. If non-composite resin
is used it can be peeled off with a dental scaler. If composite is used i should
be removed with a bur. The tooth must be supported with digital pressure during this procedure.
Patient instructionsSoft food for 1 week.
Good healing following an injury to the teeth and oral tissues depends, in part, on good oral hygiene. Brushing with a soft brush and rinsing with chlorhexidine 0.1 % is beneficial to prevent accumulation of plaque and debris.
Clinical and radiographic control after 2 weeks. Clinical and radiographic control and splint removal after 4 weeks. Clinical and radiographic control at 6-8 weeks, 6 months, 1 year and yearly for 5 years.