What is an alveolar fracture?

This post is an adaptation of the Alveolar Fracture article found in the Dental Trauma Guide

Description

• A fracture of the alveolar process; may or may not involve the alveolar socket.
• Teeth associated with alveolar fractures are characterized by mobility of the alveolar process; several teeth typically will move as a unit when mobility is checked. Occlusal interference is often present.

Etiology

Diagnosis

• A fracture of the alveolar process; may or may not involve the alveolar socket.
• Teeth associated with alveolar fractures are characterized by mobility of the alveolar process; several teeth typically will move as a unit when mobility is checked. Occlusal interference is often present
• Visual signs: Displacement of an alveolar segment. An occlusal change due to misalignment of the fractured alveolar segment is often noted.
• Percussion test Tender.
• Mobility test: Entire segment mobile and moves as a unit.
• Sensibility pulp test: Usually negative.
• Radiographic findings: The vertical line of the fracture may run along the PDL or in the septum. The horizontal line may be located at any level, from the marginal bone to the basal bone. An associated root fracture may be present.
• Radiographs recommended: Occlusal, periapical and eccentric exposure. A panoramic or a cone beam exposure may be useful.

Treatment

• Apply local anesthesia.
• Manually reposition using finger pressure labially and lingually to reposition the dsiplaced segment. 
• Clean the area with water spray, saline, or cholrhexidine.
• suture gingival laceration, if present. 
• Apply splint for stabilisation of the segment for 4 weeks
• Follow-up
  • Splint removal and clinical and radiographic control after 4 weeks. 
  • clinical and radiographic controls after 6-8 weeks, 4 months, 6 months,1 year and yearly for 5 years. 

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