scholarly journals MODERN APPROACHES TO DIAGNOSTICS AND TREATMENT OF DENTAL TRAUMA

2020 ◽  
pp. 42-49
Author(s):  
O.S. Ivanytska
Keyword(s):  
Clinical Practice ◽  
Alveolar Bone ◽  
Periodontal Regeneration ◽  
Dental Trauma ◽  
Endodontic Treatment ◽  
Diagnostic Methods ◽  
Permanent Teeth ◽  
Maximum Information ◽  
Dental Tissues ◽  
The World

Relevance of the topic. Disruption of the anatomical integrity of the dentition, occurring as a result of dental trauma, not only impairs the patient’s appearance, but can also affect the functional properties of the entire maxillofacial area. Therefore, the choice of optimal methods for treatment of dental traumas remains an urgent problem of dentistry and requires further development. The aim of this study was to offer the most effective methods for treatment of dental traumas, with a view to preserve and restore the damaged structures of teeth and provide positive long-term outcomes. Materials and methods. The research relied on the study and generalization of modern scientific literature. Results and discussion. To diagnose dental traumas and, accordingly, to determine the ways to eliminate their consequences, its classification is of great importance. In this context, the classification by Andreason gained the strongest support in the world dental community. The approaches to the diagnostics and treatment of dental traumas, which have become established in the world of dentistry, largely rely on this classification. In modern conditions, computed tomography provides the opportunity to obtain maximum information about the condition of the injured tooth and bone damage. Cone-beam computer devices are used to study the maxillofacial area, providing high image quality at low radiation exposure. Essential diagnostic methods also include pulp vitality tests (cold test and electroodontodiagnostics). In this case, to exclude the diagnosis of pulp necrosis, it is recommended to check its vitality repeatedly. Currently, as an alternative to classical restoration in case of fracture of the tooth crown, specialists consider the fixation of the proper fragment of the tooth. Recently, this method of eliminating the effects of fractures of the dental crown is becoming increasingly popular due to the significant improvement in quality and enhanced technological properties of adhesive systems and materials. The search for ways to improve medical care in cases of tooth avulsion is mainly associated with the introduction of replantation and autotransplantation of teeth in the clinical practice. It is recommended to replant a tooth with an open apex without its depulpation due to the high ability of the germinal zone and periodontium to revascularize. Immediately after returning the tooth to the alveolus, a flexible splint is applied for a period of 3-4 weeks. Further endodontic treatment is performed only in cases when revascularization does not occur and signs of apical periodontitis appear. When the root apex is formed, the tooth is replanted in the alveolus, splinted for up to 2 weeks. Endodontic treatment should begin before the splint is removed, 7-10 days after replantation. Experts suggest replanting permanent teeth with both open and closed root apices, even in cases where the tooth has been in a dry environment for more than 60 minutes. However, not always after the injury the tooth can be found or it can be destroyed so that replantation becomes impossible. Nevertheless, in modern conditions, having received an in-depth biological justification of the process of engraftment of the transplanted tooth, it becomes possible to widely use the method of autotransplantation in the clinical practice. Conclusions. Thus, based on the study of a significant array of scientific publications, we can conclude that the problems of dental trauma are increasingly attracting the attention of researchers due to the prevalence of this pathology, the complexity of its diagnostics and treatment. The current approach to the treatment of dental trauma is focused on less invasive and more biologically oriented methods of treatment of hard dental tissues, pulp, periodontal ligament and alveolar bone. Research prospects. It is important to develop the best conditions for tooth storage before replantation in order to improve the periodontal regeneration, the quality of the revascularization process, offer better types of splinting, which will ensure the regeneration of periodontal and pulp tissues, prevent inflammatory complications.

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
Keyword(s):  
Soft Tissue ◽  
Primary Teeth ◽  
Alveolar Bone ◽  
Anterior Segment ◽  
Dental Trauma ◽  
Permanent Tooth ◽  
Permanent Teeth ◽  
Normal Position ◽  
Anterior Teeth ◽  
The Impact

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

scholarly journals A Graded Multifunctional Hybrid Scaffold with Superparamagnetic Ability for Periodontal Regeneration

2018 ◽  
Vol 19 (11) ◽  
pp. 3604 ◽  
Author(s):  
Simone Sprio ◽  
Elisabetta Campodoni ◽  
Monica Sandri ◽  
Lorenzo Preti ◽  
Tobias Keppler ◽  
...  
Keyword(s):  
Cell Fate ◽  
Alveolar Bone ◽  
Tape Casting ◽  
Periodontal Regeneration ◽  
Dental Tissue ◽  
Hybrid Scaffold ◽  
Dental Tissues ◽  
Biomineralization Process ◽  
Direct Cell

The regeneration of dental tissues is a still an unmet clinical need; in fact, no therapies have been completely successful in regenerating dental tissue complexes such as periodontium, which is also due to the lack of scaffolds that are able to guide and direct cell fate towards the reconstruction of different mineralized and non-mineralized dental tissues. In this respect, the present work develops a novel multifunctional hybrid scaffold recapitulating the different features of alveolar bone, periodontal ligament, and cementum by integrating the biomineralization process, and tape casting and electrospinning techniques. The scaffold is endowed with a superparamagnetic ability, thanks to the use of a biocompatible, bioactive superparamagnetic apatite phase, as a mineral component that is able to promote osteogenesis and to be activated by remote magnetic signals. The periodontal scaffold was obtained by engineering three different layers, recapitulating the relevant compositional and microstructural features of the target tissues, into a monolithic multifunctional graded device. Physico-chemical, morphological, and ultrastructural analyses, in association with preliminary in vitro investigations carried out with mesenchymal stem cells, confirm that the final scaffold exhibits a good mimicry of the periodontal tissue complex, with excellent cytocompatibility and cell viability, making it very promising for regenerative applications in dentistry.

scholarly journals Orthodontic Forced Eruption of Permanent Anterior Teeth with Subgingival Fractures: A Systematic Review

2021 ◽  
Vol 18 (23) ◽  
pp. 12580
Author(s):  
Elisabeth Reichardt ◽  
Ralf Krug ◽  
Michael M. Bornstein ◽  
Jürgen Tomasch ◽  
Carlalberta Verna ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Alveolar Bone ◽  
Root Resorption ◽  
Statistical Significance ◽  
Case Series ◽  
Dental Trauma ◽  
Permanent Teeth ◽  
Cochrane Library ◽  
Anterior Teeth ◽  
Forced Eruption

(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.

Dental Injuries and Management

2019 ◽  
Vol 35 (06) ◽  
pp. 607-613 ◽  
Author(s):  
Likith V. Reddy ◽  
Ritesh Bhattacharjee ◽  
Emily Misch ◽  
Mofiyinfolu Sokoya ◽  
Yadranko Ducic
Keyword(s):  
Clinical Examination ◽  
Alveolar Bone ◽  
Dental Trauma ◽  
Mixed Dentition ◽  
Permanent Teeth ◽  
Radiographic Evaluation ◽  
Hard Tissue ◽  
Tissue Injuries ◽  
Dental Injuries ◽  
Type Of Injury

AbstractTraumatic dental injuries affect 1 to 3% of the population, and disproportionately affect children and adolescents. The management of these injuries incorporates the age of patients, as children between 6 and 13 years of age have a mixed dentition. This helps to preserve the vitality of teeth that may be salvaged after a traumatic event. The clinical examination of these cases involves a thorough examination of the maxilla and mandible for associated fractures and any lodged debris and dislodged teeth or tooth fragments. The objective is to rule out any accidental aspiration or displacement into the nose, sinuses, or soft tissue. After ruling out any complications, the focus is on determining the type of injury to the tooth or teeth involved. These include clinical examination for any color change in the teeth, mobility testing, and testing for pulp vitality. Radiographic evaluation using periapical, occlusal, panoramic radiographs, and cone beam computed tomography is performed to view the effect of trauma on the tooth, root, periodontal ligament, and adjoining bone. The most commonly used classification system for dental trauma is Andreasen's classification and is applied to both deciduous and permanent teeth. Managing dental trauma is based on the type of injury, such as hard tissue and pulp injuries, injuries to periodontal tissue, injuries of the supporting bone, and injuries of the gingiva and oral mucosa. Hard-tissue injuries without the involvement of the pulp typically require restoration only. Any pulp involvement may require endodontic treatment. Fractures involving the alveolar bone or luxation of the tooth require stabilization which is typically achieved with flexible splints. The most common procedures employed in managing dental injuries include root canal/endodontics, surgical tooth repositioning, and flexible splinting. Recognition and treatment of these injuries are necessary to facilitate proper healing and salvage of a patient's natural dentition, reducing future complications to patients.

scholarly journals Orthodontic movement of endodontically treated teeth

2013 ◽  
Vol 18 (4) ◽  
pp. 2-7 ◽  
Author(s):  
Alberto Consolaro ◽  
Renata Bianco Consolaro
Keyword(s):  
Clinical Practice ◽  
Dental Trauma ◽  
Endodontic Treatment ◽  
Periapical Lesion ◽  
Careful Evaluation ◽  
Endodontically Treated Teeth ◽  
Orthodontic Movement

Often there is the need of moving teeth endodontically treated or teeth still in endodontic treatment. In order to collaborate with the comprehension and substantiation of the following subjects will be discussed: 1) Orthodontic movement in endodontically treated teeth without periapical lesion, 2) Orthodontic movement in endodontically treated teeth with inflammatory periapical lesion, and 3) Orthodontic movement in teeth endodontically treated due to aseptic pulp necrosis by dental trauma. In practically all situations, endodontically treated teeth to be orthodontically moved must be subjected to a careful evaluation by the endodontist about the conditions, adequate or not, of the endodontic treatment. Then, in this paper it was sought to induce an insight for new clinical researches about the theme that may definitely prove the information obtained by interrelations of information in parallel to clinical practice.

scholarly journals Posttraumatic Displacement Management: Lateral Luxation and Alveolar Bone Fracture in Young Permanent Teeth with 5 Years of Follow-Up

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Heitor Marques Honório ◽  
Catarina Ribeiro Barros de Alencar ◽  
Edmer Silvestre Pereira Júnior ◽  
Daniela Silva Barroso de Oliveira ◽  
Gabriela Cristina de Oliveira ◽  
...  
Keyword(s):  
Bone Fracture ◽  
Alveolar Bone ◽  
Treatment Success ◽  
Dental Trauma ◽  
Public Health Problem ◽  
Permanent Teeth ◽  
Important Public Health Problem ◽  
Radiographic Findings ◽  
External Impact

Dental trauma is an important public health problem due to high prevalence and associated limitations. The external impact accounting for trauma may result in different injury types to teeth and supporting structures. This paper describes a clinical case of tooth trauma in an 8-year-old patient exhibiting the displacement of three permanent teeth with open root apexes. Although the traumatic impact resulted in two injury types to teeth and supporting tissues (lateral luxation and alveolar bone fracture), the therapeutic approach was the same in both situations. The bone and teeth were repositioned by digital pressure, stabilized by semirigid splint, and followed up at every week. After six weeks, the splint was removed. At that moment, the clinical and radiographic findings indicated normal soft/hard tissues and absence of pulp/periodontal pathologies. At the fifth year of follow-up, the treatment success of the case was confirmed, although it has been observed that all lower incisors exhibited pulp obliteration as a consequence of the dental trauma.

scholarly journals Endodontic Management of Traumatised Permanent Anterior Teeth

2020 ◽  
Vol 9 (4) ◽  
pp. 37-44
Author(s):  
Jillian M. Phillips ◽  
Catherine T. McCann ◽  
Richard Welbury
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Dental Trauma ◽  
Clinical Decision ◽  
Endodontic Treatment ◽  
Permanent Teeth ◽  
Childhood And Adolescence ◽  
Trauma Patients ◽  
Social Burden ◽  
Anterior Teeth

Traumatised permanent anterior teeth can require endodontic treatment which may be immediate as part of acute trauma management, or delayed due to the development of sequelae. This paper will enable clinical decision making by exploring a range of situations in which endodontic treatment may be indicated, and also offer practical advice regarding effective endodontic treatment for paediatric dental trauma patients. Endodontic treatment of traumatised permanent teeth in paediatric patients is often challenging. However, with timely decision making and appropriate treatment, these teeth can often last throughout childhood and adolescence thus ensuring that a young patient does not have the social burden of a missing tooth and needing a prosthesis, and has the maximum restorative options available to them as they enter adulthood.

scholarly journals Non-Vital Root Submergence for Preservation of Socket in an Adolescent - A Rare Case Report

2021 ◽  
Vol 10 (19) ◽  
pp. 1448-1450
Author(s):  
Neeta S. Padmawar ◽  
Rachita G. Mustilwar ◽  
Viddyasagar P. Mopagar ◽  
Sourabh R. Joshi ◽  
Vinay H. Vadvadgi ◽  
...  
Keyword(s):  
Bone Loss ◽  
Alveolar Bone ◽  
Treatment Plan ◽  
Treatment Options ◽  
Dental Trauma ◽  
Fracture Line ◽  
Mixed Dentition ◽  
Permanent Teeth ◽  
Root Fracture ◽  
Crown Root

Complex crown root fracture has been reported to be 5 % among the traumatic injuries to permanent teeth. In children, when fracture line extended sub gingivally, the treatment option remained was the extraction of tooth. This extraction led to alveolar bone loss and compromised the outcome of final prosthesis. Root submergence is one of the treatments options which can prevent bone loss and prepare future pontic site in a better way. In children, this technique can prevent not only bone loss but also the occurrence of space loss and development of tongue thrusting habit. Crown-root fracture is defined as a fracture involving enamel, dentin and cementum. It is reported in about 5 % of dental trauma to young children where root completion has not occurred.1 Treatment of these complex tooth fractures in aesthetic zone in growing age is always challenging for the paedodontists. The treatment should not interfere with the growth and development. Depending upon the extension of the fracture line which can result in exposure of the pulpal tissue, the crown-root fracture can be divided into two groups: complicated and uncomplicated. 2 Treatment options in cases of complicated crownroot fractures are complex, and require a multidisciplinary approach. Dental traumatology guideline and American Academy of Paediatric Dentistry has suggested fragment reattachment, orthodontic or surgical extrusion of apical portion followed by post placement, root submergence and extraction. 3 Factors like extension and direction of fracture line, pulpal involvement, tooth maturity and the length of root remaining in the alveolus govern the treatment choice. 4,5 Among above mentioned factors, position of facture line is the most important. As in case of subgingival facture line, risk of bacterial contamination is present and further this may result in gingival inflammation.6 When crown root fracture to permanent tooth occurs in mixed dentition period, goals of treatment are to preserve the tooth in arch without disturbing the growth & development of root and arch. But in case of complicated crown root fracture, when extraction is the only choice of treatment, future complications like space loss, crowding, habits like tongue thrusting and importantly loss of alveolar bone height should be kept in mind. Goals of treatment plan in such cases should be elimination of space loss, development of deleterious habit and maintenance of alveolar ridge for future pontic or implant site. Root submergence is the technique with which we can achieve these goals, keeping this in mind this case was planned and reported.

Scanning Electron Microscopy and X-Ray Analyses of Dental Tissues from a Hibernator

1976 ◽  
Vol 34 ◽  
pp. 178-179
Author(s):  
M. L. Zimny ◽  
A. C. Haller
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Body Temperature ◽  
Ground Squirrel ◽  
Alveolar Bone ◽  
X Ray ◽  
Dental Tissues ◽  
Bone Minerals ◽  
Apical Tooth ◽  
Scanning Electron

During hibernation the ground squirrel is immobile, body temperature reduced and metabolism depressed. Hibernation has been shown to affect dental tissues varying degrees, although not much work has been done in this area. In limited studies, it has been shown that hibernation results in (1) mobilization of bone minerals; (2) deficient dentinogenesis and degeneration of alveolar bone; (3) presence of calculus and tears in the cementum; and (4) aggrevation of caries and pulpal and apical tooth abscesses. The purpose of this investigation was to study the effects of hibernation on dental tissues employing scanning electron microscopy (SEM) and related x-ray analyses.

Regenereation in periodontics

2018 ◽  
Author(s):  
Murtaza Kaderi ◽  
Mohsin Ali ◽  
Alfiya Ali ◽  
Tasneem Kaderi
Keyword(s):  
Tissue Engineering ◽  
Clinical Practice ◽  
Periodontal Disease ◽  
Disease Progression ◽  
Tissue Regeneration ◽  
Surgical Procedures ◽  
Periodontal Regeneration ◽  
Guided Tissue Regeneration ◽  
Periodontal Tissues ◽  
Extensive Documentation

The goals of periodontal therapy are to arrest of periodontal disease progression and to attain the regeneration of the periodontal apparatus. Osseous grafting and Guided tissue regeneration (GTR) are the two techniques with the most extensive documentation of periodontal regeneration. However, these techniques offer limited potential towards regenerating the periodontal tissues. Recent surgical procedures and application of newer materials aim at greater and more predictable regeneration with the concept of tissue engineering for enhanced periodontal regeneration and functional attachment have been developed, analyzed, and employed in clinical practice

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