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Tooth and Pulp: What should I do about acute tooth injury?

2020-12-18
Newstar Dental Laboratory tells you what to do with acute tooth damage?
Tooth shock

1. In tooth trauma, the mild damage of the periodontal ligament is called tooth concussion, also called tooth contusion or traumatic rhizo-peritoneal inflammation

2. Clinical manifestations: slight soreness, extension or percussion pain, slight looseness or no looseness, no displacement; temperature test can be a symptom of transient sensitivity, if the pulp vitality test is done, Slightly sensitive to unresponsive; X-ray indicates normal or apical periodontal ligament widened

3. Treatment; (1) The affected tooth should be rested for one to two weeks, and the bite should be reduced if necessary to reduce the burden of the bite of the affected tooth. (2) Regular review should be carried out 1, 3, 6, and 12 months after the injury.

Tooth fracture

1. Direct impact by external force is a common cause of tooth fracture.

2. According to the location of the tooth planing, it can be divided into three types: crown fracture, root fracture, crown-root combined fracture

(1) When the crown is fractured, the dentin has been exposed and those with mild sensitivity may be treated with desensitization. For those who are more sensitive, temporary crowns can be used, lined with zinc oxide and clove oil paste for cementation. After the restoration of dentin is formed, composite resins are used to restore the crown shape

(2) Root fractures mostly occur in adults with fully formed roots. The 1/3 of the root tip with the most root fractures was broken. In some patients, the pulp vitality test is unresponsive, but a response may appear after six to eight weeks.

(3) Crown-root joints are more common with oblique crown-roots.

3. (1) For the 1/3 break of the root tip; in many cases, the upper splint is fixed and observed. If the pulp is in good condition, the bite can be adjusted. When there is necrosis of the dental pulp, root canal therapy is performed.

(2) The 1/3 of the root is broken; it can be fixed with a splint and re-examined. Adhesive splint technology is the easiest way to fix the root break. Usually fixed for three to four months. Check again every six months.

(3) When the 1/3 of the neck is broken and communicates with the gingival sulcus; there will be no self-repair. If the root length is sufficient for post crown restoration, gingival incision, orthodontic traction or intraalveolar root displacement can be used

4. The way of root fracture healing; hard tissue healing, connective tissue healing, bone and connective tissue healing, fracture line infection.

Tooth dislocation

1. The tooth is deviated by external force, so that it partly or completely detaches from the alveolar socket, which is called dislocation. Collision is the most common cause of tooth dislocation.

2. Dislocation can be divided into partial dislocation and complete dislocation. According to the direction of external force, partial dislocation can be divided into: prolapsed dislocation and embedded dislocation.

(1) Extrusive dislocation and lateral dislocation; X-rays show that the gap between the root tip and the alveolar bone is significantly widened.

(2) Embedded dislocation; X-rays show that there is no obvious gap between the apex of the tooth and the alveolar fossa, and the space between the apical membrane has disappeared.

(3) Complete dislocation of the tooth; visible emptiness in the alveolar socket.

(4) Tooth dislocation is accompanied by tearing of gums and fracture of alveolar bone.

3. Complications after dislocation

(1) Pulp necrosis

(2) The pulp cavity narrowed and disappeared

(3) Extra-root absorption

(4) Marginal alveolar protrusion

4. Treatment;

(1) Partial dislocation of teeth; ligation and fixation around. Reexamination was performed 3, 6, and 12 months after surgery.

(2) Embedded dislocation; root canal treatment is done two weeks after reduction, and the reduction should not be forced out. Young permanent teeth, let them erupt naturally.

(3) Completely dislocated teeth; implantation within 0.5 hours, 90% of the affected teeth can avoid root resorption. Put the tooth in place immediately after dislocation. If you cannot restore it immediately, you can also place the affected tooth under the patient’s tongue or in the vestibule of the oral cavity, or put it in a cup of milk, saline, or tap water. Remember to keep it dry. The maximum length cannot exceed two hours.
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