PHYSICAL AND CHEMICAL INJURIES OF THE ORAL CAVITY.pptx

1. PHYSICAL AND CHEMICAL INJURIES OF THE ORAL CAVITY

2. INJURIES TO THE SUPPORTING STRUCTURES OF THE TOOTH

3. CONCUSSION: Concussion is produced by injury which is not strong enough to cause serious, visible damage to the tooth, and the periodontal structures Clinical examination: 1) Tooth may not be mobile or displaced from its original position 2) Crown appears normal and patient may not feel difference in the occlusion. 3)Pulp gives normal response to vitality test. 4)Increase sensitivity of the tooth to percussion from any direction. Treatment: Selective grinding of the tooth to eliminate occlusal forces

4. SUBLUXATION Refers to abnormal loosening of tooth without displacement due to sudden trauma. Tooth is mobile on palpation and sensitive to percussion and occlusal forces . Rupture of the periodontal tissue Tooth becomes non vital due to severance of apical blood supply.

5. AVULSION Dislocation of the tooth from its socket due to traumatic injury. Two types PARTIAL AVULSION includes intrusion, extrusion, or facial, lingual or palatal, or lateral displacement . Partial avulsion is managed by 1)Reposition of the tooth 2) Stabilization with splints . Completely avulsed tooth can be replanted in its socket. PARTIAL TOTAL.

6. Tooth Ankylosis Fusion between the tooth and bone-----termed ankyloses Clinical Features : Ankylosis of the permanent tooth------ concomitant pulp infection which may be the underlying cause . Extensive area of the root surface involved, the tooth ------a dull, muffled sound Radiographic Features : Area of ankylosis is of sufficient size-----visible Histologic Features : Microscopic examination reveals an area of root resorption which has been repaired by a calcified material , bone or cementum, which is continuous with the alveolar bone. The periodontal ligament is completely obliterated in the area of the ankylosis Treatment and Prognosis: No treatment Good prognosis

7. PHYSICAL INJURIES OF THE BONE

8. Fractures of Jaws Automobile , industrial, and sports accidents, and fights Simple , greenstick, compound, or comminuted Simple fracture- - the bone is broken completely; the overlying structures are intact and are not exposed to exterior . Greenstick fracture ------common in children ---- characterized by break of bone in one side and bend on the other side Compound fractures ---external wound associated with the break common in road traffic accidents Bone is crushed or splintered May or may not be exposed to the exterior

9. Fractures of the Maxilla Causes include road traffic accidents, blow, fall, and industrial accidents . Classification : Le Fort I or horizontal fracture Le Fort II or pyramidal fracture Le Fort III or transverse fracture

10. Fractures of the Mandible R oad traffic accidents and physical violence . Clinical Features: Pain during movement, Occlusal de- rangement , Abnormal mobility, Gingival lacerations, Crepitus on movement, Trismus , Loss of sensation of the involved side, and Ecchymosis

11. PHYSICAL INJURIES OF SOFT TISSUES

12. Linea Alba Linea Alba is a white line seen on the buccal mucosa extending from the commissures posteriorly at the level of the occlusal plane Usually bilateral Clenching habit or bruxism CAUSES: 1) Physical irritation 2) Pressure exerted by the posterior teeth HISTOLOGICALLY: Hyperkeratosis Intracellular edema of the epithelium

13. Toothbrush Trauma Injury occurs to the gingiva Produced by the toothbrush. CLINICAL FEATURES: White , reddish, or ulcerative lesions or linear superficial erosions Involving marginal and attached gingiva of maxillary canine and premolar region Severe form Notching of the tooth and loss of alveolar bone . Pain and burning sensation HISTOLOGIC FEATURES: Epithelium shows hyperkeratosis and acanthosis adjacent to the ulcers. TREATMENT: Medications Teaching proper brushing technique.

14. Lip-biting and Cheek-biting Morsicatio labiorum and Morsicatio buccarum Commonly seen in patients who are under psychologic stress More prevalent in females CLINICAL FEATURES: Usually bilateral and seen along the occlusal line and also on the vestibular surface of the lips . Mucosa appears white and shredded, with areas of redness . Ulceration is common Vertical clefting in the free gingiva Exposure of the root Gingival ulcers .

15. HISTOLOGIC FEATURES: Areas of hyperkeratosis with keratin project Chronic inflammatory cell TREATMENT Counseling and psychotherapy

16. Denture Injuries The oral mucosa is subject to a variety of injuries as a result of the wearing of artificial dentures . ( 1) T raumatic ulcer ( 2) Generalized inflammation ( 3) Inflammatory hyperplasia (4) Papillary hyperplasia of palate (5 ) Denture base (acrylic or vulcanite) intolerance or allergy

17. Inflammatory (Fibrous) Hyperplasia CLINICAL FEATURES: D evelopment of elongated rolls of tissue in the mucolabial or mucobuccal fold area HISTOLOGIC FEATURES. Stratified squamous epithelium Pseudo epitheliomatous hyperplasia Connective tissue Bundles of collagen fibers with few fibroblasts or blood vessels TREATMENT Inflammatory fibrous hyperplasia surgically excised New denture

18. Inflammatory Papillary Hyperplasia (Palatal papillomatosis) Papillary hyperplasia is an unusual condition involving the mucosa of the palate . U nknown etiology Edentulous patients with dentures HISTOLOGIC FEATURES. Ortho keratotic stratified squamous epithelium Pseudoepitheliomatous hyperplasia

19. Sialolithiasis (Salivary duct stone, salivary duct calculus) A stone in the salivary ducts or glands is called sialolithiasis . Etiology is unclear