The tooth has been shifted in its bone socket.
Clinical
- Dislocation usually towards oral
- Often "wedged" in this position (ankylotic percussion sound!) or substantially increased mobility in the case of extended alveole
Radiological
- Tooth appears to have been shifted within its alveole with marked dislocation
- The alveole may be extended in the apical area (and simulate an apical lesion)
- Additional fracture in the root area should be ruled out
Therapy
- Repositioning (it is often necessary to loosen the tooth carefully from its wedged-in position using forceps)
- Splinting for approx. 2-4 weeks
- Root canal treatment if regeneration of the pulp appears unrealistic (dislocation > 1-2 mm in the case of a tooth in which the roots are fully grown)
Prognosis
- Vitality of the pulp maintained in > 40% of cases (more favourable prognosis if apex open)
- Increased risk of pulp necrosis in the case of additional, unfilled dentine wounds or exposed pulp
- Transient resorptions in approx. 30% of cases, rarely infection-related resorptions!