An injury to the tooth supporting structures resulting in sensitivity to percussion, increased mobility, but without displacement of the tooth.
Etiology
Same as that of Concussion
Diagnostic sign
Visual signs –Not displaced.
Percussion test –Tender to touch or tapping.
Mobility test –Increased mobility.
Pulp sensibility test –Sensibility testing may be negative initially indicating transient pulpal damage. Monitor pulpal response until a definitive pulpal diagnosis can be made.
–There will be a positive sensibility test result in about half the cases. The test is important in assessing future risk of healing complications. A lack of response at the initial test indicates an increased risk of later pulp necrosis.
Radiographic findings –Usually no radiographic abnormalities.
Radiographs recommended –As a routine: Occlusal, periapical exposure and lateral view from the mesial or distal aspect of the tooth.
Treatment
• Endodontic treatment should not be done immediately because both the sensitivity tests and discolouration may be reversed.
• Radiography to rule out any possible root fractures.
• If needed, clean the area with water spray, saline, chlorhexidine.
• Suture gingival laceration if present.
• In case of pain in relation to occlusion, slight grinding of antagonist teeth.
• Apply splint for stabilization.
• A flexible splint to stabilize the tooth for patient comfort can be used for up to 2 weeks.
Patient instructions
• Soft 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.
Follow-up
• Splint removal after 2 weeks if splint is placed.
• Pulp vitality tests are advised after duration 6-8 weeks.
• In many cases pulp necrosis may occur within 3 months..
• Action related to endodontic treatment may be taken after 2-3 months.
• Clinical and radiographic control at 4 weeks, 6-8 weeks and 1 year.
Prognosis
• Usually prognosis is fair.
• Usually pulp necrosis may occur within 3 months.
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