Fracture of the tooth – an injury due to mechanical action, and leading to the violation of the integrity of tissues. The main causes include falls, blows, and the presence in food of solid foreign objects.
Causes of broken tooth
The main causes of injuries of this type include:
- features of the anatomical structure of the tooth;
- strong mechanical impact;
error of the doctor in the process of extraction of neighboring tooth;
- severely neglected tooth decay that destroyed a significant part of the hard tissues of the tooth.
Depending on the nature decided to allocate the following types of injuries:
- chipped enamel of the tooth;
- fracture of the dentin, without opening of the pulp chamber
- fracture of dentin with exposure of the neurovascular bundle (pulp);
- fracture of the tooth root.
According to a simplified classification distinguishes complete fractures (with the pulp wound) and incomplete (without opening the pulp).
In accordance with the data of medical statistics, most of fractures are localized between the apical and median part of the crown. Damage to the root apex are extremely rare – approximately 1 patient out of 50.
It is important
Trauma is often accompanied by dislocation of the tooth (often incomplete).
Injury can result in deep caries, pathology of the roots and other physiological features of the organism.
The likely consequences of fracture of a tooth
Treatment of a broken tooth is highly recommended as soon as possible in order to avoid complications.
The consequences of fracture may be:
- the tilting and shifting of adjacent teeth and antagonists;
- abscess (limited purulent inflammation);
- phlegmon (diffuse purulent inflammation of tissue);
- inflammation of the periosteum (periostitis);
- periodontitis (inflammation of periodontal structures, including ligaments);
- pulpitis (pulp inflammation, accompanied by marked pain syndrome).
It is important
Severe complication is the displacement of the affected tooth in the soft tissue (welding).
One of the leading symptoms of this injury is severe pain, but it develops, as a rule, at the opening of the pulp chamber. Chipped enamel, the patient may not notice immediately.
In severe cases develop inflammatory swelling, preventing a full mouth opening or closing of dentition. Often that is fixed by loosening of the injured tooth unit and bleeding gums.
The degree of pain or discomfort when exposed to irritants depends on the area of the fracture and the anatomic position of the tooth. During the examination, the dentist can detect small hemorrhages (hematomas) and swelling of the vestibular zone (vestibule of mouth).
When the fracture of the tooth crown , in most cases, a significant defect. If the root fractureof the tooth is often the abnormal mobility. Probing and percussion are usually increase pain. Haemorrhage crown may acquire a pinkish hue, caused by violation of the integrity of the blood vessels of the pulp and the penetration of erythrocytes into the dentinal tubules.
Root fracture of the tooth in some cases is associated with the installation of orthopedic structures – metal pins or tabs. In such cases, the root is split lengthwise. Injury occurs either directly during the medical manipulation, or after excessive mechanical load on the tooth (particularly when inflating the occlusion).
In case of fracture of the tooth crowns are almost always visible defect, followed by the opening of the cavity, where is the pulp. If the patient had a fracture of the tooth root, the appearance of tooth mobility, in the process of percussion adjacent dental units or monitoring it with a probe, the patient feels pain. Known cases when after a fracture of the tooth crown it has gained a pinkish color. This change of tone affected tooth is associated with disruption of the integrity of nerve endings and blood vessels and infiltration of blood cells in the area of the dentinal tubules.
Modern hardware methods of research are transilluminationassisted and elektrodinamicheskoi survey (EDI). When you re-visit exactly EDI allows the doctor to assess the viability of the pulp and the feasibility of its preservation. Transilluminationassisted method involves the use of a unique flexible fiber optic light guides. Highlight with their help, allows to detect even minor violations, undetectable by visual inspection.
The most informative method of diagnosis is radiography.
It is important
Special attention should be paid to young patients because the roots can not be formed completely, and in the thickness of the gums is a growing area of the tooth permanent dentition.
Broken tooth requires careful examination, because the injury may be accompanied by violation of the integrity of the alveoli (holes) and even a fractured jaw bone.
What to do if you broke a tooth?
For the reduction or relief of pain is conducting and (or) infiltration anesthesia. Painkillers can be prescribed for oral administration, if for whatever reason the patient is forced to postpone the visit to the dental clinic.
Even in the absence of expressed pain treatment is strongly recommended as soon as possible in order to avoid displacement of adjacent teeth and other, more severe, complications.
If there are no signs of opening the pulp chamber, it is advisable to restore the damaged parts with modern composite materials. Alternatively we can recommend a manufacturer of crowns that completely cover the traumatized tooth.
When comminuted, oblique or longitudinal fracture of the tooth showing its extraction, since as a support for orthopedic design, it is not suitable. After you remove the question about an orthopedic events.
When injury of the upper or middle part of the crown with the opening of the pulp chamber is filling of the root canal and subsequent restoration of the crown.
When fracture of any kind, preserving the integrity of the root, after the complete removal of the pulp suitable installation intracanal pin, which will then serve as support for orthopedic construction.
Plisov Vladimir, dentist, medical columnist