One of the most typical emergencies in dental surgeries is trauma of teeth, especially in children. This is a situation that is very distressing for the sufferer, children and their parents, and professionals who care as it is essential to act as quickly as possible, and also trying not to upset too planning a day of sightseeing.
There are different types of dental trauma that must be addressed by both differently.
First you have to establish how, when and where the injury occurred and whether there was any period of unconsciousness. Then it proceeds to the extra oral and intraoral examination for possible injuries to the soft tissues s. Relative to the teeth must be determined if they move, whether they have been displaced, and if color changes. You must also take intraoral radiographs to determine the extent of the injury and the status of the neighboring structures.
The types of fractures that can occur in the crown of the teeth, whether temporary or permanent, according to the WHO classification (1) are:
- enamel fracture infringement
- enamel fracture uncomplicated
- fracture of enamel and dentin
- complicated fracture with pulp exposure tooth
In primary teeth if fractures are uncomplicated one can choose to file the cutting edges or even if the child can be placed restoration cooperates with glass ionomer or composite. If fractures are complicated you can make pulpotomies, nerve removal of the pulp chamber, in less serious cases and if this is not possible tooth extraction would take place.
In the permanent teeth it will proceed the same way for uncomplicated fractures. Even if the tooth fragment is preserved and this is not dehydrated, should save water or saline can be repositioned by resins. If the fracture is complicated need to determine the severity of exposure of the pulp. If this is minimal you can opt for placing a pulp protection and restoration to make composites. It is important to monitor the vitality of the tooth in time to discard the pulp necrosis or tissue death. If this happens should perform a root canal to remove all the pulp tissue. Similarly, if the fracture exposed the pulp was extensively proceeding with the endodontic directly.
Dr. Xavier Calvo
- Application of the International Classification of Diseases to Dentistry and Stomatology. ICD-DA3rd edn. Geneva: WHO, 1995.