Le Big Live: Part 3

Overview

In this final session of the "Big Live" evening we are joined by dental trauma expert Dr Cesar de Gregorio for an in-depth and pragmatic guide to managing traumatic injuries in permanent teeth. We explore the latest evidence-based protocols from the International Association of Dental Traumatology (IADT), with a strong emphasis on the diagnostic power of CBCT and the biological principles behind modern treatment decisions. The lecture covers a range of injuries, from fractures and luxations to the critical management of avulsions.

Key Topics Covered

• The critical role of CBCT in accurately diagnosing fractures and displacements, often revealing complexities missed on 2D radiographs
• Key updates from the IADT guidelines, including the significantly reduced extra-oral dry time threshold for avulsed teeth (now ~20-30 minutes)
• A modern approach to vital pulp therapy, advocating for partial pulpotomy even in mature teeth with complicated crown fractures
• Management protocols for luxation injuries, highlighting the high probability of necrosis in mature teeth and the 3-month pulp sensibility monitoring window
• The use of intracanal corticosteroids as a medicament immediately after pulpectomy in avulsed teeth to mitigate inflammatory resorption
• Correct flexible splinting ("stabilisation") techniques and the importance of avoiding overly rigid splints

Clinical Relevance

This session delivers an essential update on managing traumatic dental injuries, which are often stressful and complex clinical emergencies. We are provided with clear, evidence-based protocols from the latest IADT guidelines that can be immediately applied to improve decision-making and prognosis for patients suffering from dental trauma.

Learning Outcomes

After watching this, we should be better able to:

• Utilise CBCT imaging to better diagnose and plan treatment for traumatic injuries
• Apply the updated IADT guidelines for managing luxation, avulsion, and root fracture cases
• Confidently consider vital pulp therapy as a treatment option for complicated crown fractures in mature teeth
• Understand the importance of flexible splinting and the biological rationale for using intracanal corticosteroids