Journal
AUSTRALIAN DENTAL JOURNAL
Volume -, Issue -, Pages -Publisher
WILEY
DOI: 10.1111/adj.12989
Keywords
Dental traumatic injury; root canal treatment; complicated fracture; inflammatory resorption; pulp necrosis
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The dental pulp can respond in both positive and negative ways to traumatic dental injuries. The most serious negative responses are pulp necrosis and infection of the root canal system. Certain injuries require root canal treatment as part of emergency management, while others need regular monitoring of the pulp.
The dental pulp may respond favourably or unfavourably to traumatic dental injuries. The most serious unfavourable responses are pulp necrosis and infection of the root canal system. These cause apical periodontitis and/or external inflammatory resorption of the tooth. The following injuries require root canal treatment as part of their emergency management-(A) complicated crown fractures (but some may be suitable for conservative pulp treatments, such as pulp capping, partial pulpotomy or pulpotomy), (B) complicated crown-root fractures, (C) supra-crestal coronal third root fractures and (D) injuries where pulp necrosis is predictable or highly likely to occur AND where there has been damage to the root surface and/or periodontal ligament with the aim of preventing external inflammatory resorption. This latter group of injuries are avulsion, intrusion, lateral luxation with a crown fracture, extrusion with a crown fracture (all in fully developed teeth) plus avulsion with a crown fracture and intrusion with a crown fracture (both in incompletely developed teeth). All other injuries should not have root canal treatment commenced as part of the emergency management, but they must be reviewed regularly to monitor the pulp for any adverse changes to its status, particularly pulp necrosis and infection of the root canal system.
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