Tooth Fracture Treatment

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Emergency treatment of traumatic
injuries-fractures

• Crown fracture
• without pulp exposure
• with pulp exposure
• with necrotic pulp exposure
• Horizontal root fracture
• Avulsed teeth

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Crown fracture without pulp exposure
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Crown fracture without pulp exposure
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Crown fracture with vital pulp exposure
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Crown fracture with necrotic pulp exposure

• Earlier accident
• Caries
• Deep restoration
• Severing of pulpal vessels

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Horizontal root fracture
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Management

• Wire composite splint
• Orthodontic bracket splint
• Resin splint
• Titanium trauma splint

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Titanium trauma splint
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Avulsion

• Emergency treatment at the site of injury
• Emergency treatment at the dental office
• Completion of endodontic treatment

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Emergency treatment at the site of injury

• Tooth replanted as soon as possible
• Reinserted into the socket
• Use of suitable transport media

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Emergency treatment at the dental office

• Put the tooth in saline
• Splinted
• Do not curette, sterilize
• Implant the tooth firmly into the socket

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Avulsion
complete displacement of the tooth out of the
socket with neither crown or root fracture

• Incidence
• 1-16 of all traumatic injuries of permanent
  teeth.
• 7-13 of primary dentition
• Male Female ratio 31
• Age group 7-11 yrs
• Maxillary central incisors are commonly avulsed

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Avulsion

• Pick up the knocked-off tooth,
• Holding the crown without touching the
  root
• Best to hold with sterile gauze
• Do not disturb the viability of PDL
• Do not dry the tooth

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How to store avulsed tooth

• Transport media
• Hanks balanced salt solution (HBSS)
• Via span
• Saliva
• Milk
• Water

Milk or saliva of injured person
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Factors affecting the success of replantation

• Extra oral time
• Shorter the extra oral period, better the
• prognosis for retention of the replanted
  tooth

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Stabilization

• Wire composite splint
• Orthodontic bracket splint
• Resin splint
• Titanium trauma splint

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Completion of endodontic treatment

• Prepare access cavity
• Root canal debridement and preparation
• Place calcium hydroxide paste
• Refresh the canal walls fill with gutta-percha

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Case-report
Courtesy Franklin.s.weine
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Case report (contd)
Post obturation
2 years recall
3 years recall
17 years recall
Courtesy Franklin.s.weine
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Conclusion

• Endodontic emergencies are a challenge for both
  diagnosis and management.
• Knowledge and skill in several aspects of
  endodontics are requiredfailure to apply these
  will result in serious consequences for the
  patient
• It is satisfying and rewarding to successfully
  manage a distraught patient who has an emergency.

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• Stunning Dentistry believe in delivering No
  Compromise Dentistry assisted with Top- notch
  technology. Our team of Internationally acclaimed
  specialists craft smiles with a personalized
  touch making sure our clients receive the best
  services in the world of dentistry.

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