scholarly journals Dental fractures: types, causes, and treatment

Author(s):  
Samar A. Bamofleh ◽  
Alanoud F. Alotaibi ◽  
Aidel A. Alshahrani ◽  
Shoroug M. Alahmadi ◽  
Abdulaziz I. AlHumaidan ◽  
...  

Studies indicate that the management of dental fractures might be challenging because many cases present with minor, hard-to-discover traumas, requiring extensive evaluation and diagnostic procedures. Accordingly, adequate management can only be achieved by establishing a proper diagnosis, drawing an adequate treatment plan, and conducting regular follow-up appointments. We have discussed the different causes, types, and treatments of dental fractures. The commonest causes include impaction by trauma, whether direct or indirect. Many traumatic events were reported in the literature, and age and carious lesions are important factors to consider. Many types of dental fractures were also reported in the literature, including root fractures, crown root fractures, enamel-dentin fractures with and without pulp exposure or crown fractures, enamel infractions, and fractures. Other types include avulsion, intrusion, extrusion, lateral luxation, concussion or subluxation, splinting, and alveolar segment fractures. The treatment should be integrated based on the fracture type, and adequate follow-up should be established to achieve the best predictive outcomes.

2018 ◽  
Vol 20 (3) ◽  
pp. 158
Author(s):  
Renata Espíndola Silveira ◽  
Isabela Pereira Furtado ◽  
Marco Aurélio Carvalho ◽  
Lawrence Gonzaga Lopes ◽  
João Batista Souza ◽  
...  

Abstract This clinical case was aimed at reporting and discussing diagnostic methods for early detection and preventive treatment of proximal carious lesions. The patient presented to the dental clinic seeking treatment of a problem she reported as being “dental caries”. The patient’s orthodontist diagnosed dental caries, by means of radiographic exam. There was no evidence of any proximal carious lesion in the intraoral examination. The bitewing radiographs presented a radiolucent area limited to enamel in the mesial of maxillary left-second-bicuspid. For the purpose of confirming the intraoral diagnosis, an immediate tooth separation was performed. The immediate separation was unable to provide sufficient access; thus, the slow separation approach was performed. After 24-hours, tooth separation of 1mm was obtained, providing enough access for clinical examination. The proximal areas were evaluated by transillumination and impression taking. During the visual inspection, an area of enamel staining was observed, with no roughness due to tactile inspection and the evaluation by transillumination and impression showed no cavitation. The following preventive treatment plan was endorsed: oral hygiene instructions with emphasis to the importance of flossing the proximal areas, and healthy dietary habits. After a 5-years period of follow-up, the enhanced oral hygiene and heathy dietary habits were observed. A clinical examination with immediate tooth separation and bitewing radiographs was performed and showed no cavitation. Thecombination of methods for detecting carious lesions in proximal surfaces was effective in obtaining a diagnosis of cariesin the permanent dentition. The absence of cavitated lesions must be indicative of preventive treatment.Keywords: Dental Caries. Preventive Dentistry. Diagnosis, Oral.ResumoEste caso clínico objetivou relatar e discutir os métodos diagnósticos para detecção e tratamento preventivo de lesões cariosas proximais. A paciente procurou atendimento restaurador com queixa de cárie diagnosticada por exame radiográfico realizado após término de seu tratamento ortodôntico. Ao exame clínico não havia suspeita de lesão cariosa. A avaliação radiográfica revelou, na face mesialdo dente 25, presença de área radiolúcida limitada à metade externa do esmalte. Para confirmação do diagnóstico realizou-se a separação interdentária imediata, porém como a mesma não permitiu adequada visualização foi realizada a separação mediata e após 24 horas obteve-se adequada separação (1 mm) para o exame clínico. Em seguida, a superfície proximal foi avaliada por transiluminação e moldagem. Durante a inspeção visual foi constatada área de manchamento do esmalte, com ausência de rugosidade pela inspeção tátil e a avaliação tanto por transiluminação da superfície proximal, quanto por moldagem revelou ausência de cavitação. Devido o diagnóstico obtido o seguinte tratamento preventivo foi indicado: reforço de higiene oral com ênfase na importância do uso do fio dental e hábitos dietéticos saudáveis. Após 5 anos de acompanhamento melhoria da higiene oral e hábitos dietéticos foram constatados. O exame clínico com separação interdentária imediata e exame radiográfico revelaram ausência de cavitação. Conclui-se que a combinação de métodos de detecção de lesões cariosas proximais foi efetivo no diagnóstico da cárie dentária na dentição permanente. O resultado deste relato de caso mostrou que a ausência de lesões cariosas cavitadas deve ser um indicativo de tratamento preventivo.Palavras-chave: Cárie Dentária. Odontologia Preventiva. Diagnóstico Bucal.


2021 ◽  
pp. 75-75
Author(s):  
Krstina Doklestic ◽  
Dragan Vasin ◽  
Bojan Jovanovic ◽  
Dzemail Detanac ◽  
Ivana Lesevic

Introduction. Isolated jejunal perforation (IJP) without any associated injuries is rare in blunt abdominal trauma (BAT). It most commonly occurs in decelerating trauma. Diagnosis of traumatic intestinal perforation may be difficult in the first hours after injury so unrecognized ?missing? intestinal injuries incidences are as high as 24%. Unrecognized traumatic bowel perforation without adequate treatment leads to the intestinal leakage into the peritoneal cavity, making progress in secondary peritonitis and potentially lethal complications. Case outline. We presented the case of 43 years old women injured in road traffic accident. She was admitted to emergency surgery after diagnostic procedures according to the protocol for trauma. Initial examination, and body computed tomography (CT) revealed orthopedic injuries. Daily monitoring and follow-up examinations were done, she did not complain of any discomfort nor pain in the abdomen and there were no signs of abdominal injury. Two days after trauma, follow-up abdominal CT revealed highly suspected jejunum perforation, still with no signs of pneumoperitoneum. Laparotomy was performed and diagnosis of IJP was confirmed. Bowel perforation was surgically closed in two layers, followed by drainage of septic collections, abdominal saline lavage and primary abdominal closure. The patient was discharged on the seventh postoperative day without complications. Conclusion. In the case of BAT due to severe traumatic force in patient with nonspecific clinical signs of abdominal trauma on initial clinical and radiological examination, follow-up in a short period is necessary, to detect hidden jejunal perforation. Surgery is a life-saving for those patients and treatment of these injuries usually require simple operative procedures.


2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Márcio de Carvalho Formiga ◽  
Magda Nagasawa ◽  
Jamil Awad Shibli

Mandibular full-arch restoration is a good and successful treatment option for totally edentulous patients. In the past years, several studies have described the placement of 4 to 6 implants to restore this type of case; however, an option using 3 dental implants placed in strategic and specific positions could also be an alternative. Therefore, this case report describes a full-arch rehabilitation on 3 straight, immediately loaded implants after 8 years of follow-up. The restoration presented no biological or technical complications during this follow-up period, showing that an adequate treatment plan was able to allow good results using this treatment option.


2018 ◽  
Vol 11 (1) ◽  
pp. e227177 ◽  
Author(s):  
Amena Khan ◽  
Ramesh Singaraddi ◽  
Deviprasad Shetty ◽  
Gabriel Rodrigues

Tuberculosis (TB) is a global disease and if not adequately treated can lead to morbidity and mortality. Though genitourinary TB is common and only next to pulmonary TB, cutaneous ‘ulcerative’ tuberculosis of the scrotum is not reported so far in the literature. We present a 32-year-old man with a non-healing scrotal ulcer and underwent excision. Histopathology was consistent with TB. Antitubercular therapy was given and at the end of a year’s follow-up, there has been no recurrence. TB of the scrotum should be considered in the differential diagnosis of scrotal ulcers. Proper diagnosis and adequate treatment will offer a cure to such patients.


2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Luiz Mendes ◽  
Laisa Laxe ◽  
Leandro Passos

This report describes the 10-year follow-up data of a patient who underwent fragment reattachment to the maxillary central incisor after coronal fracture with pulp exposure as well as the procedures followed for functional and esthetic adjustments. A 9-year-old female patient presented at the clinic of dentistry at the State University of Rio de Janeiro with a coronal fracture and pulp exposure of the right maxillary central incisor that had occurred immediately after an accident. The intact tooth fragment was recovered at the accident site and stored in milk. The treatment plan followed was to perform direct pulp capping and tooth fragment reattachment. When the patient was 14 years old, adhesion between fragment and remaining tooth was lost, and fragment reattachment was performed. Five years later, the same tooth presented clinical discoloration and absence of sensitivity during pulp vitality tests. Subsequently, a new treatment plan was formulated, which included endodontic treatment, followed by nonvital tooth bleaching and light-cured composite resin restoration. An esthetic and natural-looking restoration was achieved. Tooth fragment reattachment is not a temporary restorative technique and requires functional and esthetic adjustments over time to maintain the biomimetic characteristics of traumatized anterior teeth and predictable outcomes.


2019 ◽  
Vol 56 (4) ◽  
pp. 947-950
Author(s):  
Anca Melian ◽  
Gabriel Melian ◽  
Catalina Iulia Saveanu ◽  
Sorina Mihaela Solomon ◽  
Cristian Levente Giuroiu ◽  
...  

Treatment of crown root fracture is complex and requires an accurate diagnostic and treatment plan. The purpose of this article is to report a case of a maxillary central incisor with a crown-root fracture with pulp exposure treated and rehabilitated with the preservation of pulp vitality using a micro-pulpotomy and pre-mixed bioactive endodontic cements followed by zirconia restauration, a bioinert ceramic material, milled using CAD/CAM technology. The preservation of pulp vitality using premixed bioceramic materials, ensures the continuation of dentinogenesis with its benefits, higher resistance of radicular walls against fracture, smaller diameter of apical foramen as well as creating conditions over time for a post retained crown with better aesthetic results.


2016 ◽  
Vol 33 (S1) ◽  
pp. S641-S641 ◽  
Author(s):  
G. Sobreira ◽  
C. Ferreira ◽  
S. Alves

IntroductionHuntington's Disease is an autosomal dominant neurodegenerative disease characterized by motor, psychiatric and cognitive symptoms. Irritability, affective disorders, apathy and psychosis are among the most frequent psychiatric symptoms and can predate the pre-clinical period.ObjectiveThe authors’ goal is to understand the complexity of Huntington's disease clinical presentation. Additionally, we present an illustrative clinical case.AimsTo convey the importance of collecting reliable information in order to make a proper diagnosis.MethodsA PubMed database review was performed using “Psychiatry”, “Psychiatric”, “Symptoms” and “Huntington's Disease” as keywords; retrieved papers were selected according to their relevance. The patient clinical record was reviewed.ResultsThe authors report a case of a 39-year-old woman, who was referred in 2014, to a psychiatrist because of depressive mood and suicidal ideation with two suicidal attempts in the past 5 years. However, she did not disclose her family history of Huntington's disease neither to her GP nor her psychiatrist. She never complied with the treatment plan and was admitted, in November, into a psychiatric unit because of subtle motor changes and apathy, which had resulted in personal neglect. The diagnosis could only be made after a family interview was held and the family medical history was revealed.ConclusionsCorroborative history from caregivers is of extreme importance in psychiatry. Early detection of symptoms can help mitigate the disease social impact. In our patient's case, by the time of proper diagnosis, she was estranged from her family and had endured distressing psychiatric symptoms without adequate treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2010 ◽  
Vol 35 (4) ◽  
pp. 482-486 ◽  
Author(s):  
F. F. Lima ◽  
R. C. Pascotto ◽  
A. R. Benetti

Clinical Relevance Due to the risk of pulp exposure in deep carious lesions, stepwise excavation can be a conservative and successful option for selected cases, when signs and symptoms of a normal pulp are present.


2017 ◽  
Vol 31 (2) ◽  
pp. 102-108
Author(s):  
Josué Martos ◽  
Luana P. Amaral ◽  
Luiz Fernando M. Silveira ◽  
Melissa F. Damian ◽  
Cristina B. Xavier ◽  
...  

Aim: To present a a therapeutic approach in a case series of teeth that suffered some root fracture at different thirds with a follow-up period of 24 months. Summary: Dental trauma occurs with great frequency to the maxillary incisors, and, sometimes, horizontal root fractures are caused. The classification and severity of horizontal root fractures are based on the location of the fracture line and on the degree of dislocation of the coronal fragment. Diagnosis of horizontal root fractures is based on clinical findings, sensibility tests, and principally in radiographic and cone-beam computed tomography (CBCT) examination. The following cases report describes the diagnosis and treatment of four maxillary central incisors with horizontal root fractures. In three of the cases described, the healing occurred through the interposition of connective tissue where radiographically was possible to observe a radiolucent at the level of the fracture line and the rounding of the fragment angles. In one case, the healing occurred by calcified tissue, which can be seen radiographically in the fracture line, but the fragments are in close contact. In addition to a proper treatment plan, the International Association of Dental Traumatology (IADT) stresses the importance of patient compliance with follow-up, and daily care visits for better healing after dental trauma. Knowledge of existing protocols for this type of injury and periodic monitoring of cases has shown the success of the treatment so far.


2020 ◽  
Vol 23 (2) ◽  
pp. 28-33
Author(s):  
Indira Apriantika ◽  
Agung Krismariono

A healthy and beautiful smile can affect appearance and confidence. One of the aesthetic problems in dentistry that is often complained of by patients is excessive gingival display (gummy smile). The excessive gingival display can be caused by several factors, one of which is altered passive eruption (APE). One of the treatments to correct gummy smile related to APE is crown lengthening. Crown lengthening can be with bone reduction (gingivectomy with bone reduction) or without bone reduction (gingivectomy). Crown Lengthening with bone reduction is a surgical procedure that aims to maintain the dentogingival complex and to improve smile aesthetics. The purpose of this case report is to determine the crown lengthening with bone reduction (gingivectomy with bone reduction) procedure as a gummy smile treatment related to APE .A23-year-old female patient, came to Dental Hospital of Universitas Airlangga with complaints of her upper gum which not in the same length and the teeth looked short, she considered her smile was less aesthetic. After conducting analyses relating to aesthetics and periodontal tissue, crown lengthening with bone reduction was chosen for this patient treatment. The treatment results are quite good, visible gingival margins that matched the gingival zenith and improved patient's smile profile. APE as the etiology of patient's gummy smile can be corrected. There are no post-surgical complications such as excessive pain and infection. A proper diagnosis, treatment plan, and good techniques can produce a harmonious smile on the patient.


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