كسور الأسنان و تدبيرها لبياً Broken teeth and managed to Pia

Broken teeth and managed to Pia

    Traumatic dental injuries rating Classification:
    l by Andreasen1994
     crown fractures racture Crown
     break root Root Fracture
     tissue injuries around the Sunni Periodontal tissues injuries
     Avean Dental temporary and evolving Primary Developing teeth injuries
     soft tissue injuries Soft Tissues injuries
     bone injuries Booster Supporting Bone injuries

    Predisposing factors for traumatic injuries to the teeth PREDISPOSING FACTORS
    1 - the emergence of the upper incisors.
    2 - Palace of the upper lip.
    3 - mental and physical disabilities.
    4 - extensive caries and large renovations.
    5 - abuses forming tissue that infect the Sunnis.

    Traumatic injury mechanisms:
    Shock occurs, either directly or indirectly.
    Variable factors in the traumatic force that determines the type and extent of injury
    1. Shock strength (mass and velocity).
    2. Traumatic body flexibility.
    3. Traumatic body shape.
    4. Traumatic direction of the force.

    The epidemiology of traumatic injuries EPIDEMIOLOGY
    Differs from the spread of Traumatic dental injuries and clearly by the following variables:
    1 - Gender:
    The incidence of dental close in the interim.
    Incidence among males twice as high in females in the permanent teeth.
    2 - Age:
    The time period between the ages of 2-5 years is the most frequent trauma in children in the temporary teeth.
    Back injury rate to rise in the field of age 8-12 years.
    3 - teeth المرضوضة:
    Infect the majority of traumatic injuries upper front teeth, especially the upper folds
    4 - the evolution of society:
     whenever the evolution of society has increased the practice of various sports and the use of various means of transportation, which predispose to increase the proportion of traumatic injuries.
    5 - the seasons of the year:
     The percentage of dental trauma in some areas in the summer and in other regions in the winter, depending on geographical location.

    Tooth fractures
    - Crown fractures
    A - includes port only break
    B - broken crown simplex: which includes the port and Ivory
    T - breaking the Crown complex, which includes the port, ivory and pulp
    Crown and root fractures
    W - Breaking a simple crown and root
    C - Breaking the crown and root complex
    - Root fractures
    _ A horizontal root fracture.
    B _ vertical root fracture.
    C _ break Leaning root.

    Temporary tooth fractures: The flexibility of the bone Ocean and roots Palace makes a fraction less إحتملا while rising incidence of other injuries "displacement".
    Often the effects of trauma transmitted to the permanent tooth buds, so here treatment strategy depends on maintaining the integrity of the permanent teeth, and through the following:
    Make sure not to invade the root of the provisional Age pod bud permanent tooth.
    Monitor the healing to avoid injury following the bud Age of Permanent.

    1 - Crown fractures:
    1 - breaking the port:
    Treatment here refine the edges of the coarse fraction or restoration Balcolmbouzayt.
    2 - Breaking the crown is complex:
    Ivory covers Almenkhv Bmeat calcium to prevent pulp hurt.
    Rebuilding age Balkambozi or the Alkambomir.

    3 - broken crown complex:
    Includes breakage port, ivory and pulp.
    Do not cover the procedure is indicated in the temporary dental pulp.
    Treatment:
    A - pulp exposure for a short period and medullary tissue is still alive:
    Pulp Balformukrizul the amputation is indicated when the peak is incomplete.
    Pulp amputation is indicated Bmeat calcium when the peak is incomplete.
    B - pulp Mtamot:
    Indicated a conventional endodontic treatment and zinc oxide channel stuffing and Alozjanol or tooth extraction as the case may be.

    2 - root fractures:
    § better warning of root fractures apical third fractures which keeps most of these teeth on the vitality and is characterized by a simple movement.
    § Age absorbs with the apical part Broken naturally but must be monitored on an ongoing basis by the rays.
    § fractures of the cervical third or medium where extraction is indicated.
    Permanent teeth fractures:
    Breakage occurs because of the strength of rammed front outweigh the shear forces of the port and ivory.
    And supports to maintain the vitality of the pulp in these injuries:
    1 - Ivory exposure and time elapsed before coverage.
    2 - After breaking the surface of the pulp.
    3 - the stage of development of the root.
    4 - fracture was associated with other injuries such as dislocations.
    5 - an area of ​​pulp exposure.
    6 - elapsed time of exposure of the pulp and even treatment.


    1 - breaking the port:
     In case cracked port) arent or interruption in port المواشير without loss of tooth structure (no need to deal with the attention to the fact that this case is often associated with injuries at the level of the supporting tissues.
     In case of small fractures edge roughness can be removed without breakage restored.
     and can be in the larger fractures that Tim restored Balkambozi.

    2. Breaking the crown, which includes the port and Ivory:
    These fractures lead to the exposure of vulnerable channels of the oral environment, and thus expose the pulp to decay and التموت or compensatory reaction form restorer Ivory.
    Wide channels in the permanent teeth additional factor poses a risk to the safety of the pulp.
    These fractures are processed either re-connect broken fibula if any or restoration Balkambozi.
     rare occurrence pulp die after treating uncomplicated crown fractures (increase of only 0.7%).
    However, this figure may rise when accompanied by a break with injury on the crown Sunni (انخلاع) cause disorder in the core rotation.

     break the crown complex:
    Occurs in complex fractures of the crown exposure and rupture in the pulp, and rely treatment of complex fractures of the crown on four factors:
    1 - an area of ​​exposure.
    2 - Time interval between exposure and treatment.
    3 - the degree of development and growth of age.
    4 - The possibility of restoration of the crown of the infected tooth.
    And in any case can follow the following chart:
    In the event of Age peak incomplete:
    1 - If the exposure is small and it did not take more than 24 hours, we cover the direct pulp.
    2 - If the broad exposure conducting conventional endodontic treatment.
    In the case of the young age:
    1 - In case of a small exposure to either:
    Live coverage "smaller exposure time of 24 hours"

    Or partial amputation of the pulp "exposure time ranges (1-7) days"
    Vital considerations:
     The ivory pipe exposure and exposure of the pulp allows germs attack directly and indirectly on the pulp, which responds pneumonia later the formation of granulation tissue
     The bacteria can also penetrate the pipe exposed ivory and presence in the medullary tissue. But impedes bacterial colonization and reproduction in case the safety of the medullary blood circulation.
     When applied coverage pulposus or pulpotomy partial (A) with the application of calcium hydroxide (region shaded), the healing following will happen region Mtamoth Mtaktherh will see off under calcium hydroxide (B) and under this area will begin in response healing differentiation photographers Ivory and produced for ivory new, This occurs after 2-3 weeks after treatment, at this time, more than 5 micrometers of the new Ivory deposited per day, which means a significant barrier of solid tissue under medullary wound after 2-3 months.



    In the case of the expiration of more than a week we process channel pulposus complete and Nhacoha Bmeat calcium to incite nascent or apical conformation.

    2 - In case of large exposures:
    Exposure time less than a week we partial amputation of the pulp.
    In case the time we process week the pulposus Bmeat channel calcium.
     observe the situation:
    The situation must be monitored for at least 4 years. And ensure the success of these treatments over time through:

    1 - the absence of clinical symptoms of the condition.
    2 - there is no proof of injury satisfactory radial inside or around the root.
    3 - the continuous development of the tooth root in the incomplete development of the roots.
    4 - radial surveillance and clinical verification of the continuity of the fabric steel bridge.
    5 - sensory response to the alarm off.
     conformation peak:
    When this happens you die full pulp it is necessary to eradicate the entire pulp, although the success of the eradication of the pulp regard to the extent of maturity of the root.
    Here, you must apply calcium hydroxide which prevents absorption of internal and external to the root:
     application of calcium hydroxide (3-6) months until the end of the bridge steel at the peak.
     Then we the traditional treatment of the root canal.
    > The warning depends on the thickness of the root sophisticated in terms of age with the most sophisticated root has the best warning <


    Crown and root fractures:
    Treatment:
    Part lift broken as soon as possible after the occurrence of breakage, blessed with the edges of the fracture under the gum by chisel ports, and covered the rest of the Age temporary crown end edges above the gum line.
    Conducting the final restoration after healing of the gums, which usually takes 2-3 weeks.
    When you remove the Broken Nkhaddr part topically and then a fibula.
    And "If the longitudinal part of the root broken more than one-third of the length of the root is indicated then rip this age."
    Can handle the case edge breakage of transfer under the gum above the gums, and cut the gums alone or surgically cut the gums and bone.
    Where cuts alveolar bone for a distance of 2 mm below the fracture line and at the same meeting excised pulp and fillings channel in the same session.
    And can handle the crown and root fractures that do not include the pulp re-connect the broken piece by ivory linkage system after cutting section buried under the gums or reconstruction بحشوات the Alkambozi.
    Surgical treatment can be performed بقلع Age and dragging them to the appropriate level and then held in place by a splint (2-3) weeks, and then excised the pulp and fillings channel, and after (1-2 months) can restore the crown of age and are required for the success of This method can be the root length appropriate.
    Or calendar been where proving bracketed on age or attend the wire in the form of his dogs prove in a channel Age by cement and tracking gums Age movement and requires spare gums after end traction Age, proving age in place (2-3) months.
    And restoration Age can either re-persons by Alkambozi or ceramic crown.
    And disadvantages of this method long period of treatment, but it gives a good cosmetic results.

    Breaking the root:
    Of a complex nature of the involvement of each of the mortar, ivory and pulp and Rabat in these lesions.
    . Injury can be considered for Taji Koveh of section تقلقل with the trauma of the ligament and nerve package vascular coronary mantel. Unlike the apical section, which remains mainly is Mradwd.

     clinically: appear elongated Age and normally bantered حنكيا.

     radiographic appearance:
    Lines or balmy radially line separates the root to two or more pieces. Widget peak always remain in place, while Tzah the is usually coronary piece.
    Dentist may be forced to make more pictures with the change of angle in the peak direction by coronary (10-15) degree in the event of lack of clarity of line breakage.
    To facilitate the healing must be re-Age to its statute, in cases of fractures root accompanying the shift, you must return the item coronary into place gently, if this procedure is usually painless and rarely referred to local anesthesia, after re-piece, taken radiograph then apply a splint harsh or half harsh.

    Fracture can be either horizontally or vertically.
    Horizontal fractures associated with either die in the pulp or to stay alive.
    Pulp neighborhood: If little or no movement, or if the fracture in the middle third or peak, it is not necessary to perform endodontic treatment.

     The negative response of pulp vitality tests do not necessarily mean dying pulp.
     must install age Bajabirh for a period of not less than three months.

    Horizontal fractures with pulp die:
    Fractures of the coronary third of the root:
    Treatment depends on the location of the fracture and its relationship tip of alveolar Extrusion.
    If the break above the top of the alveolar extrusion we a segmental coronary broken and edges Nczb as a periodontal tissue above the line break to take a good edition allows us to renovating Age putted and metal heart then Ntoj the Age crown or crown molded jacket.
    If the break below the top of the alveolar extrusion Valmaaljh be harder
    And the problem can be solved in two ways:

    1 - If the fracture deep under the alveolar extrusion summit reveals the the surgically root surface and the alveolar bone and still is bad this way they change the site of the gums and cosmetic situation becomes unacceptable.

    2 - The second method include treatment for negative calendar terms of fillings channel and prove the heart with a metal wedge Leisure calendar root in the vertical direction until the surface of the root development permit the taking good edition for the restoration of Age
    Fractures of the middle third of the root:
    l conservative treatment:
    If a simple fracture fragments in normal, pulp alive: can happen union between Czitin, and placed under surveillance and age scan vitality and conducted periodic radiographic examinations and success of this treatment depends on how close the fragments and the effectiveness of the installation and the degree of infection.

    In the case of near fragments of each with a die in the pulp:
    Vtsttab endodontic treatment and the use of stabilizers within the root.
    Treatment success: in the absence of clinical signs and symptoms,
    And note the magnitude of Malatya on simple the image radial fracture line.
    Surgical treatment:
    When the fragments are far apart conducting surgical treatment is like cutting the peak, where still widget peak and are recurrent padding in the event that the remaining root enough.
    In the case of being short and not enough to be of use of the Botad within the channel installation and inside the bone.

    Fracture in the apical third:
     is the best warning of where that age is constant.
     we eradicate Plot peak then Nhaco channel retrograde
     after treatment are watching the situation and may have to install age Paljbaúr.



    Vertical fractures:
     fracture line parallels the longitudinal axis to age.
     more common in dental treatment for Pia.
     pockets on Sunni narrow deep.
     pain on the tooth when biting.
     may not be obvious clinically or radiologically and baptize here to:
    1. Raise slice of direct vision and to verify the existence of partial or complete fracture.
    2. The use of optical fiber or coloring.
    3. Taking more than radiograph and more than one angle.

    Treatment of vertical fractures:
     vary whether treatment Age Single or multi-root roots.
    In a single tooth root:
     Full breakage: Bad warning and advised بقلع age.
     fraction of the coronary segment: remove the broken part with a drag calendar for the remaining part.
     fracture in the apical third we remove the broken part surgically.
    In multi-rooted teeth:
     If the breakage includes only one root of age we Bpetrh.
     can be used glass Alharda the Cement Association because of its properties in the reform of vertical root fractures.
     You can also use amalgam or the MTA.