انت هنا الان : شبكة جامعة بابل > موقع الكلية > نظام التعليم الالكتروني > مشاهدة المحاضرة

Stabilization of Replanted Teeth

الكلية كلية طب الاسنان     القسم التقويم والاطفال وطب الاسنان الوقائي     المرحلة 5
أستاذ المادة حسن فليح فرحان السلطاني       6/7/2011 11:17:25 AM

Lec. 13                                Pediatric dentistry                                      Dr. Hassan Wateefi

 

Stabilization of Replanted Teeth:

After replantation of a tooth that has been avulsed, a splint is required to stabilize it during at least the first week of healing.
The acceptable splint should meet the following criteria:
1. It should be easy to fabricate directly in the mouth without lengthy laboratory procedures.
2. It should be able to be placed passively without causing forces on the teeth.
3. It should not touch the gingival tissues, causing gingival irritation.
4. It should not interfere with normal occlusion.
5. It should be easily cleaned and allow for proper oral hygiene.
6. It should not traumatize the teeth or gingiva during application.
7. It should allow an approach for endodontic therapy.
8. It should be easily removed.
9. The splint should also allow mobility of the replanted tooth that is comparable with the normal mobility of a tooth. Rigid stabilization seems to stimulate replacement resorption of the root. Rigid stabilization can be used for root fractures, to enhance the opportunity for a calcified tissue repair. Therefore use of heavier wires is recommended.
The bonded resin and wire splint satisfies all the criteria just described. It can be used in most situations requiring the stabilization of one fracture tooth or more.

Types of splint:
1. The bonded resin and wire splint
2. Bonded brackets and arch wire splint.
3. Suture and a bonded resin splint.
4. Button with stainless steel ligature and acrylic caps.
5. Othrodontic arch wire.
6. Fiber-filled acrylic
7. Titanium trauma splint

10- Root Fractures: Include:
1. Coronal or cervical fracture: We usually remove the crown and if the remaining root is long enough we do RCT. Some time we need orthodontic extrusion of remaining apical fragment and then we do post and core and permanent filling. If remaining tooth is short do extraction.
2. Middle 3rd fracture: Treated by RCT. involving both the coronal and apical fragments and objurgated with silver point that acts as a splint.
3. Apical 3rd fracture. Fractures in the apical third are often repaired without treatment. Some time RCT. of the coronal fragments and apical fragment is removed surgically.
The pulp in the permanent teeth with fracture root has a better chance to recover, since the fracture allows immediate decompression and circulation is more likely to be maintained.
          Usually require a radiograph for detection, unless the tooth is particularly loose    and the fracture occurred close to the gingival margin. Treatment may involve root canal therapy, splinting, or extraction; depending on the exact nature of the root fracture.     

 Prevention of Dental Trauma:   
Most dental trauma is preventable.  Prevention of dental injury is considered to be more important than treatment as with other general and oral diseases. The concept of dental trauma prevention can be directed in the following levels:
A. Primary Prevention:
•   With the use of anticipatory guidance the dental practitioner could educate and direct the parent and child to a path of good oral health from infancy to adulthood. This is through educational programmes either directly performed in schools, medical and dental centers or indirectly through the mass media like radio, journals, television ... etc.
•   Most injuries to the primary dentition occur when infants begin to walk age 1-4 years old, since they do not have the coordination to protect themselves from their falls.
1. The dentist should suggest to the parents to remove coffee tables or other objects that may cause harm.
2. Homes should be monitored for potential tripping and slipping hazards.
3. Childproofing measures should be taken, especially for toddlers, and these include covering plug outlets, removal of open electrical extension cord, etc.
4.  Parents can place gates across stairs and pad sharp table edges.
• As the child grows older he or she will become more active in sports. This dentist should encourage the use of helmets and professionally fabricated mouth guards.     
•  Car seat belts should always be worn, and young children should be secured in appropriate car seats.
•  Screening programs could be conducted for school children to identify those with high anatomic and behavioral risk for occurrence of traumatic injury to the anterior teeth so appropriate preventive measure such as preventive orthodontic treatment can be implemented.

B. Secondary Prevention:
•   Traumatized anterior teeth should be treated as soon as possible to maintain pulp vitality and to prevent further complication.

C. Tertiary Prevention:
• This is a level of rehabilitation. Space maintainers should be considered if the traumatized teeth are avulsed or extracted, till the time when fixed bridge is indicated. 

 

 


المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .