Decision-Making in Complex Dento-Alveolar Trauma in the Maxillofacial Region

Emergency departments are frequently faced with the evaluation and management of traumatic maxillofacial and dento-alveolar injuries. Acute traumatic dento-alveolar injuries of permanent teeth occur mainly in children, adolescents, and younger adults, but maxillofacial injuries are common even in elderly. The difficulty of dento-alveolar trauma treatment mostly comes from the complexity of the injuries and the fact that they often are associated with other injuries, particularly brain injuries. Surgical decision-making and management of maxillofacial and dento-alveolar trauma are based on proper diagnosis of the type of injury, treatment techniques, prospective treatment planning and follow-up, and most importantly associated injuries and overall physiologic state of the trauma patients. The most common procedures employed in managing of maxillofacial and dento-alveolar trauma include surgical, endodontic, restorative, and orthodontic treatment. Particular attention to the avoidance of overtreatment is to be paid. The purpose of this chapter is therefore to give an overview surgical decision-making after complex dento-alveolar trauma.