Management of trauma to the anterior segment of the maxilla: alveolar fracture and primary incisors crown and root fracture

2021 ◽  
Vol 33 (2) ◽  
pp. 16-20
Author(s):  
Muna S Khalaf ◽  
Bayan S Khalaf ◽  
Shorouq M Abass

Background: An injury to both the primary and permanent teeth and the supporting structures is one of the most common dental problems seen in children. Splinting is usually difficult or impossible to perform in the primary dentition (due to diminutive room size and lack of patient cooperation). Healing must, therefore, occur despite mobility at the fracture line, usually resulting in interposition of connective tissue. In some instances, infection will occur in the coronal pulp. The present study reported a case of trauma to the anterior primary teeth and alveolar bone in a four year old child. The trauma has caused fracture to the crowns and roots of the primary anterior teeth. The following case was managed in a procedure that may provide primary teeth subjected to trauma a better chance than extraction with a better prognosis. Case presentation: a 4 and a half year old child was subjected to trauma in anterior segment of maxilla. Suturing of the torn soft tissue was the first step followed by pulpotomy for the left primary lateral incisor. Fixation of the right primary central and lateral incisors was done by acid etch wire fixation. Both clinical and radiographic follow up was carried out for 6.4 years. Results: healing of the soft tissue was observed after one week and completed after two months. Fixation of the teeth continued for ten months. The fracture lines in the roots remained in position. Clinically there was no sign of any pulpal inflammation or necrosis. Radiographically, no signs of infection to the surrounding tissues could be seen, no resorption in the alveolar bone, external or internal resorption of the root did not happen also. After ten months fixation ended and the wire was removed. At that time there was normal resorption of the roots of the primary incisors in relation with the normal development of the permanent incisors. After 3 years both permanent central incisors erupted in their normal position. After 6.4 years all four permanent incisors erupted into occlusion in their normal position. Conclusion: primary teeth with root fractures and severely mobile coronal fragments can be treated by a conservative approach. The severity of the sequels is directly related to the degree of permanent tooth formation (child’s age), type of dental trauma and extent of the impact. Key words: trauma, primary incisors, fractured crown and root

Author(s):  
Elisabeth Reichardt ◽  
Ralf Krug ◽  
Michael M. Bornstein ◽  
Jürgen Tomasch ◽  
Carlalberta Verna ◽  
...  

(1) Background: To assess orthodontic forced eruption (OFE) as a pre-restorative procedure for non-restorable permanent teeth with subgingival dental hard tissue defects after dental trauma. (2) Methods: A systematic electronic search of three databases, namely, MEDLINE, Cochrane Library, and EMBASE, revealed a total of 2757 eligible publications. Randomized controlled clinical trials (RCT), retro- and prospective clinical studies, or case series (with a minimum of three patients) were reviewed. (3) Results: Thirteen full-text papers were included: one RCT, one prospective clinical trial, two retrospective cohort studies, and nine case series. Within case series, statistical significance between age and cause of fracture (p < 0.03) was determined. The mean extrusion rate of OFE was 1.5 mm a week within a four to six weeks treatment period followed by retention. Three OFE protocols for maxillary single teeth are available: 1. OFE without migration of gingiva and alveolar bone, 2. OFE with gingival migration and slight alveolar bone migration, and 3. OFE with migration of both gingiva and alveolar bone. (4) Conclusions: The current state of the evidence suggests that OFE is a feasible pre-treatment option for non-restorable permanent teeth. OFE can promote the migration of tooth surrounding hard and soft tissues in the esthetic zone. Root resorption does not seem to be a relevant side effect of OFE.


2015 ◽  
Vol 5 (2) ◽  
pp. 70-72
Author(s):  
Nitin Agarwal ◽  
Debanti Giri ◽  
Saurabh Mathur ◽  
Kirti Agarwal

Dental fusion also called ‘synodontia’ is a rare dental developmental anomaly in which the union of two independently developing primary or permanent tooth buds occurs. Tooth fusion is defined as union between the dentin and / or enamel of two or more separate developing teeth. The fusion may be partial or total depending upon the stage of tooth development at the time of union. The etiology of fusion is still unclear. The overall prevalence of the tooth fusion is approximately 0.5%. Fusion may be unilateral or bilateral and most often occurs in primary teeth with more predilections for anterior teeth. Clinically fused anterior teeth frequently have a groove or notch on the incisal edge that goes in buccolingual direction and radiographically, the dentin of fused teeth always appears to be joined in some region with separate pulp chambers and canals. Hence the cases of fusion of permanent teeth in different ages are presented.Bangladesh Journal of Dental Research and Education Vol.5(2) 2015: 70-72


2020 ◽  
Author(s):  
Lucía Caeiro Villasenín ◽  
Clara Serna Muñoz ◽  
Amparo Pérez Silva ◽  
Ascensión Vicente ◽  
Andrea Poza Pascual ◽  
...  

Abstract Children are vulnerable to dental trauma, especially in the first two year of life.The objective was to determine whether trauma in temporary teething causes alterations in the development of permanent teething. Searches were made in May 2020 using PubMed, MEDLINE, MEDES, Scopus, Lilacs, and Embase. Papers in English, German, and Spanish, without restrictions in the year of publication, were included. The quality of the studies was analyzed using the NOS Scale.The search retrieved 537 references, and 7 studies were included for a qualitative analysis. The results showed that trauma to a deciduous tooth can damage the bud of the permanent tooth. Enamel discoloration and/or hypoplasia were the most common sequelae in the permanent teeth after trauma to the primary predecessor. The type and severity of sequelae in the permanent tooth are associated with the development phase of the bud. Children with trauma of their primary teeth should receive check-ups until the eruption of the permanent teeth for the early diagnosis and treatment of possible sequelae. Intrusion of the primary tooth was the trauma that caused the most damage and enamel alterations the most frequent sequelae.


2017 ◽  
Vol 6 (2) ◽  
pp. 36-45
Author(s):  
Catherine T Mccann ◽  
Richard R Welbury

This article aims to provide a practical clinician's guide to assessing and diagnosing dental trauma involving permanent teeth in children and young people, and for carrying out appropriate, guideline supported acute management. Timely referral to specialist paediatric dental services is crucial in more complex trauma presentations and will lead to improved outcomes for the dentition. Appropriate acute management by the primary clinician optimises the prognosis of any traumatised tooth and this article will focus on the emergency treatment of the traumatised permanent tooth.


2007 ◽  
Vol 77 (4) ◽  
pp. 735-741 ◽  
Author(s):  
Richard Scott Conley ◽  
Scott B. Boyd ◽  
Harry L. Legan ◽  
Christopher C. Jernigan ◽  
Craig Starling ◽  
...  

Abstract An impacted or missing permanent tooth can add significant complications to an otherwise straightforward case. When multiple impacted teeth are present, the case complexity increases further. Developing a treatment sequence, determining appropriate anchorage, and planning and executing sound biomechanics can be a challenge. The following case report illustrates a patient reportedly diagnosed with mild scleroderma as an adolescent. He presented for orthodontic treatment as an adult with multiple retained primary teeth and multiple impacted teeth. Diagnosis, treatment planning, and various methods of managing guided eruption of impacted teeth will be discussed. Following orthodontic treatment that required extraction of multiple primary and permanent teeth as well as exposure and ligation of multiple permanent teeth by an oral surgeon, the patient finished with a significantly improved functional and esthetic result.


2017 ◽  
Vol 2 (s1) ◽  
pp. 49-52 ◽  
Author(s):  
Monica Monea ◽  
Tudor Hănțoiu ◽  
Alexandra Stoica ◽  
Ramona Vlad ◽  
Alexandru Sitaru

Abstract Background: Desquamative gingivitis (DG) is a non-plaque-induced, blistering and painful condition occurring most frequently on the labial aspect of the attached gingiva of anterior teeth. The incidence of DG is highest around 50 years of age, and usually indicates the presence of oral or systemic diseases. The purpose of our study was to determine the impact of DG on periodontal health by recording the plaque index, gingival index and gingival bleeding index in a group of patients with DG, compared to healthy controls. Materials and methods: Recordings of specific indices were performed in a group of 26 patients with DG and compared with 24 healthy individuals. These were followed by radiographic examinations in order to assess the loss of marginal alveolar bone. Results: The results showed that patients with DG had a statistically significant increase in periodontal indices, with more gingival inflammation and plaque retention compared to the control group (p <0.05). The highest scores for gingival inflammation were recorded in patients with DG, but on radiographic evaluation the difference was related only to gender, men being more affected by alveolar bone loss in both groups (p <0.05). Conclusions: The incidence and severity of gingival inflammation proved to be higher in patients with DG, which calls for better preventive and maintenance treatment protocols in this group of patients. Early diagnosis and initial-phase periodontal treatment are very important in preventing further tissue breakdown.


2014 ◽  
Vol 39 (1) ◽  
pp. 30-34 ◽  
Author(s):  
SG Tulsani ◽  
N Chikkanarasaiah ◽  
S Bethur

Objectives: Biopure MTAD™, a new root canal irrigant has shown promising results against the most common resistant microorganism, E. faecalis, in permanent teeth. However, there is lack of studies comparing its antimicrobial effectiveness with NaOCl in primary teeth. The purpose of this study was to compare the in vivo antimicrobial efficacy of NaOCl 2.5% and Biopure MTAD™ against E. faecalis in primary teeth. Study design: Forty non vital single rooted primary maxillary anterior teeth of children aged 4-8 years, were irrigated either with NaOCl 2.5% (n=15), Biopure MTAD™ (n=15) and 0.9% Saline (n=10, control group). Paper point samples were collected at baseline (S1) and after chemomechanical preparation (S2) during the pulpectomy procedure. The presence of E. faecalis in S1 & S2 was evaluated using Real time Polymerase Chain Reaction. Results: Statistical significant difference was found in the antimicrobial efficacy of NaOCl 2.5 % and BioPure MTAD™ when compared to saline (p&gt;0.05). However, no statistical significant difference was found between the efficacies of both the irrigants. Conclusions: NaOCl 2.5% and BioPure MTAD™, both irrigants are equally efficient against E. faecalis in necrotic primary anterior teeth. MTAD is a promising irrigant, however clinical studies are required to establish it as ideal root canal irrigant in clinical practice.


2019 ◽  
Vol 35 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Andomar B. F. Vilela ◽  
Priscilla B. F. Soares ◽  
Fabiana S. de Oliveira ◽  
Tales C. Garcia-Silva ◽  
Carlos Estrela ◽  
...  

2019 ◽  
Vol 43 (1) ◽  
pp. 5-10
Author(s):  
Jackeline Nogueira de Paula Barros ◽  
Thayssa Augusto Assis de Araújo ◽  
Thais Rodrigues Campos Soares ◽  
Michele Machado Lenzi ◽  
Patrícia de Andrade Risso ◽  
...  

This retrospective study aimed to evaluate the dental trauma profile in primary and permanent teeth from patients between 0 and 15 years old who attended the Faculty of Dentistry of the Federal University of Rio de Janeiro. Data regarding gender, age, trauma classification, tooth type, and affected tissues were obtained from dental records. The data were analyzed descriptively and by the χ2 test (p &lt; 0.05). Data associated with 333 traumatized teeth (70% primary and 30% permanent teeth) were included. The mean ages of children with affected primary and permanent teeth were 3.35 ± 2.02 and 9.09 ± 2.43 years, respectively. Males presented more permanent teeth with trauma (64.4%) than primary ones (55.6%; p = 0.085). The upper central incisors, both primary (68.9%) and permanent (69.4%), were the teeth most commonly affected. Primary teeth showed a higher frequency (p &lt; 0.001) of supportive tissue trauma (73.3%) and lower frequency (p = 0.001) of hard tissue trauma (40.7%) than those in permanent ones (51.5% and 60.6%, respectively). The most frequent trauma in the supportive tissue was subluxation (27.2%) and permanent lateral luxation (42.0%). In the hard tissues, permanent teeth presented a higher prevalence of trauma than primary ones (p = 0.001), however this difference was not statistical significant when each type of fracture injury was evaluated individually (p &gt; 0.005). With affected primary teeth, there was a greater frequency of trauma in the gingival mucosa (31.0%; p = 0.022); in the permanent ones, traumatic lesions in the chin region were the most prevalent (20.8%; p = 0.009). Trauma was recurrent in 26.3% of primary teeth and in 20.2% permanent teeth. Therefore, primary and permanent teeth showed distinct trauma profiles, suggesting that distinct preventive and therapeutic approaches are needed for these two groups.


2020 ◽  
Vol 9 (40) ◽  
pp. 2951-2954
Author(s):  
Shivani Kharpate ◽  
Nilesh Rathi ◽  
Pooja Vilas Gomase ◽  
Sudhindra Baliga ◽  
Nilima Thosar

BACKGROUND Health education is an essential aspect for prevention of oral health problems in school children. Dental trauma can result in damaging the tooth, periodontal ligaments, and sometimes even alveolar bone and gingiva. These traumatic injuries to the anterior teeth in young children are tragic but are an ignored problem. They can result in aesthetic and functional problem with possible impact on child’s quality of life as anterior teeth are essential for phonetics, mastication, integrity of supporting tissue and also mental and psychological wellbeing of children. This dental emergency can be best handled by the school teachers and the staff members when it happens in a school. So, the study was conducted to assess the knowledge and attitude of the school teachers regarding the emergency management of dental trauma and sensitize them on the subject. METHODS This is a pre- and post-test study performed using self - designed questionnaire provided to the school-teachers of Wardha district. RESULTS Knowledge of 98 % teachers increased after the activity whereas knowledge of 2 % of school teachers was the same as earlier. CONCLUSIONS Sensitization of the school teachers improved their awareness and attitude to manage the dental trauma and avulsion injury of teeth in school. KEY WORDS Tooth Avulsion, Emergency Dental Traumatic Care, School Teachers


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