Traumatic tooth refers to trauma (injury) to the teeth and/or periodontium (gums, periodontal ligaments, alveolar bone), and nearby soft tissues such as lips, tongue, etc. The study of dental trauma is called dental traumatology.
Video Dental trauma
Prevalence
Traumatic tooth is most common in younger people, accounting for 17% of injury to the body in those aged 0-6 years compared with an average of 5% at all ages. It is more often observed in men than in women. Traumatic tooth injury is more common in permanent teeth compared to deciduous teeth and usually involves the maxillary front teeth.
Maps Dental trauma
Type
Tooth fracture
- Enamel violation
- enamel fracture
- The enamel-dentin fracture
- Dental fracture complex
- Tooth root fracture
Periodontal tool injury
- Subluxation of teeth (teeth knocked loose)
- Teeth flexibility
- Tooth intrusion (tooth congestion to tooth socket)
- Avulsion of teeth (teeth knocked out)
Injury to support bone tissue (alveolar fracture)
This injury involves the alveolar bone and may extend beyond the alveolus. There are 5 different types of alveolar fractures:
- Fracture communicated on socket wall
- Fracture wall sockets
- Dentoalveolar Fracture (segmental)
- Maxillar fracture: Le Fort fracture, zygomatic fracture, orbital explosion
- Mandibular fracture
Traumatic injuries involving alveolus can be tricky because they do not occur in isolation, very often appearing along with other types of tooth tissue injuries.
Signs of dentoalveolar fracture:
- Change to occlusion
- Some teeth move together as segments and are usually displaced
- Bruised attached gingiva
- Gingiva along the fracture line is often torn
Investigations Ã,: Requires more than one radiographic display to identify the fracture line.
Treatment : Repositioned teeth replaced with local anesthesia and stabilize the cell phone segment with splint for 4 weeks, stitching soft tissue wounds.
Soft tissue lasers, most often lip and gingiva.
Soft tissue injury is presented generally in association with dental trauma. Areas usually exposed are lips, buccal mucosa, gingiva, frenum and tongue. The most common injuries are lips and gingivae. For the lips, it is important to remove the presence of foreign objects in wounds and lacerations through careful examination. Radiography can be taken to identify potential foreign objects.
Smaller gingival lasers usually resolve spontaneously and require no intervention. However, this could be one of the clinical presentations of alveolar fracture. Bleeding of the gingivae especially around the edges may indicate injury to the dental periodontal ligament.
Facial nerves and parotid channels should be examined for any potential damage when the buccal mucosa is involved.
Deep tissue injuries should be repaired in layers with stitches that can be absorbed by the resort.
Risk factors
- Little child
- Sports, especially contact sports
- Stabs on tongue and lips
- Military training
- Acute changes in barometric pressure, ie tooth barotrauma, which may affect diver divers and aviators
- Class II Malocclusion with skeletal overjet and Class II relational enhancement
Prevention
Routine use of oral protection during sports and other high-risk activities (such as military training) is the most effective prevention of dental trauma. Custom made oral shields are preferred as they are suitable, providing adequate comfort and protection. However, studies in various populations at high risk for dental injuries have repeatedly reported poor adherence to ordinary use of oral protective agents during activities. In addition, even with regular use, the effectiveness of dental injury prevention is incomplete, and injuries can still occur even when the mouthguard is used because the user is not always aware of the brand or the best size, which inevitably results in a poor match.
One of the most important actions is to provide knowledge and awareness about tooth injuries for those involved in sports environments such as boxing and schoolchildren where they are at high risk of suffering dental traumas through extensive educational campaigns including lectures, leaflets, posters that should presented in an easy to understand way.
Management and maintenance options in the future
Management depends on the type of injury involved and whether it is an adult baby or teeth. The Trauma Tooth Guide is an evidence-based and up-to-date source to assist dental trauma management. If the teeth completely healed the baby's front teeth should not be replaced. The area should be cleaned gently and the child is taken to the dentist. Adult tooth (which usually erupts around the age of 6 years) can be replaced immediately if clean. See below and the Dental Trauma Guide website for more details. If the teeth are palpable, make sure the teeth are permanent (the oldest teeth should not be replanted, and instead the wound should be cleaned for adult teeth to erupt).
- Reassure the patient and keep them calm.
- If teeth can be found, take with crown (white part). Avoid touching the root.
- If the teeth are dirty, wash briefly (10 seconds) under cold water but do not brush your teeth.
- Put the tooth back to the socket where it is missing, be careful to place it in the right way (matching the other teeth)
- Invite the patient to bite a handkerchief to hold the teeth in position.
- If it is not possible to change teeth immediately, place them in a glass of milk or a container with patient saliva or on the cheek of the patient (keeping it between the teeth and the inside of the cheek - note this is not suitable for young children who may swallow teeth). Carrying teeth in water is not recommended, as this will damage the delicate cells that make up the inside of the tooth.
- Immediately seek emergency dental care.
The "Save a Tooth" poster is public and available in several languages ​​- Spanish, English, Portuguese, French, Icelandic, Italian - and available on the IADT website.
When a wounded tooth is painful when functioning because of damage to the periodontal ligament (eg, dental subluxation), temporary splinting of injured teeth can reduce pain and improve eating ability. Splinting should only be used in certain situations. Splinting in lateral and extrusive luxation has a worse prognosis than root fracture. Avulsion permanent teeth should be rinsed gently under tap water and immediately replanted in the original socket inside the alveolar bone and then dissolved temporarily by the dentist. Failure to reinstall avulsion teeth within the first 40 minutes after injury can lead to a very poor prognosis for teeth. Management of injured primary teeth is different from permanent dental management; primary primary teeth should not be replanted (to avoid damage to permanent dental crypt). This is because it is close to the top of the main tooth to the permanent tooth underneath. Permanent teeth can suffer from malformations of teeth, affected teeth and eruption disorders due to trauma to primary teeth. The priority should always be to reduce the potential damage to the underlying permanent tooth.
For other injuries, it is important to keep the area clean - by using a soft toothbrush and an antiseptic mouthwash such as chlorhexidine gluconate. Soft foods and avoiding contact sports are also recommended in the short term. Dental care should be sought as soon as possible.
Complications after dental trauma management
Not all trauma symptoms are imminent and many of them can occur months or years after the initial incident so prolonged follow-up is required. Common complications include pulp necrosis, pulp obliteration, root resorption and damage to primary tooth teeth in primary dental trauma. The most common complication is pulp necrosis (34.2%). 50% of teeth suffering from trauma associated with avulsion undergo ankylotic root resorption after median TIC (elapsed time between traumatic events and diagnosis of complications) of 1.18 years. Teeth with some traumatic events also showed a higher likelihood of necrosis of the pulp (61.9%) than teeth with single traumatic injury (25.3%) in the study (1)
Pulp necrosis
Pulp necrosis usually occurs either as ischemic necrosis (infarction) caused by impaired blood supply in the apical foramen or as liquefactive necrosis associated with infection after dental trauma (2). Signs of pulp necrosis include
- Persistent gray to dull teeth
- Radiographic signs of periapical inflammation
- Clinical signs of infection: tenderness, sinus, pus, swelling
Treatment options will be extracted for the primary teeth. For permanent teeth, endodontic treatment may be considered.
Pulpal obliteration
4-24% of traumatized teeth will have some degree of pulp destruction characterized by loss of radiographic space pulp and yellow coloration of the clinical crown. No treatment is required if it is asymptomatic. Treatment options will be extracted for symptomatic first tooth. For symptomatic permanent tooth, root canal treatment is often challenging because the pulp chamber is filled with calcified material and the 'drop off' sensation entering the pulp chamber will not occur.
Damage to the succeeding tooth
Tooth trauma in the deciduous tooth can cause damage to the permanent tooth. Damage to permanent teeth especially during the development stage may have the following consequences:
- Crown of dilation
- Malformations like Odontoma
- Detention of permanent dental bacteria
- Root dilated
- Capture of root formation
Primary teeth
Sequelae potential may involve pulp necrosis, pulp destruction and root resorption. Necrosis is the most common complication and the assessment is generally made on the basis of color with radiographic monitoring. The color change can mean that the tooth is still vital but if this remains there is a possibility of no importance.
See also
- Barotrauma teeth
- Dental syndrome cracked
References
External links
- Dental Trauma Guide, an interactive tool for evidence-based dental trauma
- International Association of Dental Traumatology
- US Dental Emergency Doctors Association
- Trauma Tooth Patient Information
Source of the article : Wikipedia
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