tooth fracture
Introduction
Introduction to tooth folding Tooth fracture refers to the fracture of the tooth caused by the sharp mechanical external force. It is more common in the upper anterior teeth, often accompanied by damage to the pulp and periodontal tissues. In severe cases, it is often accompanied by alveolar process fractures, which are often broken according to clinical practice. The position is divided into: crown fold, root fold, crown fold. basic knowledge The proportion of illness: 0.005% Susceptible people: no special people Mode of infection: non-infectious complication:
Cause
Cause of tooth decay
Direct impact by external force is a common cause of tooth fracture, and it can also occur due to biting of sandstone, broken bone and other hard objects during chewing.
Prevention
Tooth prevention
The prevention of this disease should be carried out according to the cause, avoiding the prevention of violent trauma and chewing and biting into hard objects such as sand and graves to directly damage the teeth. Brushing your teeth regularly can promote the normal development of enamel, which is important for increasing the hardness of teeth and reducing tooth fracture.
Complication
Tooth fracture complications Complication
Often complicated with alveolar fractures.
Symptom
Tooth decay symptoms common symptoms toothache tooth injury dentition sparse shock
Type:
According to the anatomical part of the tooth, it can be divided into two types: the crown fold and the crown root joint and the fold type. In terms of the relationship between the damage and the pulp, the tooth fold can be divided into two categories: exposed pulp and unexposed pulp.
1. Crown folds can be divided into horizontal folds and oblique folds; rear crown folds can be divided into oblique folds and longitudinal folds.
2. Root fracture traumatic root fracture is more common in adult teeth with complete root formation, because the support tissue of young permanent teeth is not as firm as the root formation, and often avulsion or dislocation during trauma, generally does not cause root fracture, causing root fracture The force is the impact of direct impact and facial landing. The root fold can be divided into 1/3 of the neck side, 1/3 of the root and 1/3 of the root tip. The most common one is the 1/3 of the root tip. The crack line is perpendicular to the long axis of the tooth or has a certain slope. The traumatic longitudinal fold is rare. The X-ray examination is an important basis for diagnosing the root fracture, but it cannot show all the cases of root fracture. The central ray must be fractured during filming. When the lines are consistent or parallel, the fracture line can be displayed on the X-ray film; if the angle between the center ray and the fracture line is greater than positive, minus 15° to 20°, it is difficult to observe the fracture line; at the same time, only when the center When the mineral content of the corresponding ray is reduced by 6.6% or less, the sparse area can be observed on the X-ray film. The X-ray film not only contributes to the diagnosis of the root fracture, but also facilitates comparison at the time of review.
Some dental examinations did not respond to the pulp vitality test, but there was a reaction after 6 to 8 weeks. It is speculated that the non-viable reaction is caused by the "shock" caused by the damage of the blood vessels and nerves during the trauma of the pulp; The gradual recovery of its "shock" revived.
The rate of pulp necrosis of root fractures is 20% to 24%, while the rate of pulp necrosis of permanent teeth without root fracture is 38% to 59%. The difference may be due to the gap between the root fractures, which is conducive to the drainage of pulp inflammation. For this reason, whether or not pulpal necrosis occurs after root fracture depends mainly on the severity of the wound, the dislocation of the broken end and the mobility of the coronal section. When the root is broken, there may be loose teeth and pain, such as crown Lateral displacement can be caused by sulcus bleeding, tenderness of the root mucosa, etc. Some root fractures have no obvious symptoms at the early stage, and symptoms gradually appear after several days or weeks. This is due to edema and occlusion resulting in the separation of the root fracture ends.
3. Crown root fold A small part of the total number of dental trauma, more common with oblique crown and root fracture, the pulp is often exposed.
4. Longitudinal folds are more common in the posterior teeth, with the highest incidence of the first molars, followed by the second molars, indicating that force is the main cause of the disease, in addition, the incidence of non-medullary teeth and larger tooth defects, the incidence More than 80%.
In the direct cause of longitudinal folding, chewing hard objects account for a large proportion.
After the longitudinal folding of the teeth, the most obvious symptoms are chewing pain, followed by the feeling of elongation. The longitudinal roots of the roots also have periodontal pockets of varying depths. X-ray films can aid diagnosis.
Examine
Dental folding examination
The crack of the tooth surface is consistent with the developmental groove and extends beyond the edge. The crack can be deeply stained by the iodine or the fine shadow of the tooth in the tooth. The same tooth of the same name often occurs symmetrically.
X-ray films clearly defined the location of the fracture and the presence or absence of an alveolar fracture.
Diagnosis
Diagnosis of tooth fracture
diagnosis
1. Crown fold: history of trauma, crown enamel dentin fracture, if not exposed to the teeth only sensitive symptoms. Those who have been exposed can see the bleeding point in the pink puncture point, the pain is obvious.
2. Root fracture: There is a history of trauma, the teeth have different degrees of pain and looseness, the more the neck is more painful and loose, the more obvious it can be diagnosed by X-ray film.
3. There are many pulp exposures, and there are obvious bite pains. X-ray examination and transillumination can help diagnose.
Differential diagnosis
The disease should be differentiated from tooth wear.
