Injuries in the jaw and face area as a result of traumas such as falling, hitting, and blowing; It is not limited to the soft tissue, but may result in the deterioration of the integrity of the tooth and surrounding hard tissues. The first thing to note about injuries in the maxillofacial region is that traumas affecting these regions may also affect the skull base. The first step to be taken in case of a vital head and neck injury is to apply to the emergency units of the hospitals. For this reason, the patient should first be referred to the health institution that is equipped in this regard. If there is no vital risk as a result of the medical examination performed after the examination of radiographic head and neck examinations in the emergency clinics and there is a fracture in the maxillofacial region, the second step to be taken is to apply to the nearest oral, dental and maxillofacial surgery specialist. This application can be made with the referral made by the emergency doctor or in line with the patient's own wishes and possibilities. It should not be forgotten that the intervention in jaw injuries should be done quickly, and a maxillofacial surgeon should be consulted without wasting time.
It is a part of the treatment protocol to get your tetanus vaccine as recommended in the emergency health institution for dental and jaw injuries.
If you have received a blow to your jaw that may cause a fracture and your emergency response has been completed in the hospital, the following are the steps to do;
Because the jaw bones have a complex joint system and many muscles are exposed to the effects of forces in different directions, it can be inconvenient and risky to let them heal on their own. Interventions are usually carried out by connecting the jaws to each other and then fixing the fracture line with osteosynthesis plates.
If you have a fracture or displaced tooth;
- The broken piece is in saline or in this If the tooth cannot be obtained, you should come to the clinic quickly after being protected in milk.
- If the tooth is not broken as a result of the impact, but a little bit has come out of the socket, you should apply to the clinic without trying to remove the tooth any more.
- If it has come off and fallen to the ground, apply to the clinic as soon as possible in physiological saline without touching the root surface of the tooth. In such a case, if you cannot reach serum physiology, you should apply to the clinic by washing the fallen tooth with clear water and keeping it in milk or the patient's own saliva.
How to Treat Dental Traumas?
Tooth fractures caused by a hard object require immediate treatment. In such a case, even if there is no pain in your broken tooth, dental examination and intervention will prevent more serious complications that may occur in the future.
Fractures that occur in your tooth are treated with different treatment methods according to the tooth tissue covered by the fracture line.
Different treatment options are applied according to the types of tooth fractures seen below, and the duration of treatment can vary between 6 months and 2 years. For example, a tooth that did not need root canal treatment after trauma may need root canal treatment between 6 months and 2 years. Again, the tooth that responded negatively to vitality tests after trauma; It can respond lively after 6 months.
The form of the fractures in your tooth can be as in the examples below. Regardless of the form of the fracture in your tooth, if the broken piece has not disappeared, you can put the broken piece in a glass of serum isotonic, if you can't find the serum, in a glass of milk or whatever. It is very important for the success of the treatment that you apply to a dental clinic urgently by preserving the stain in its own saliva. observed as cracks. In some cases, it can cause sensitivity in the early period. In such cases, fluoride applications and sensitivity treatment can be performed. However, in most cases, follow-up is sufficient without the need for treatment in cases of enamel cracks.
This type of cracking can occur as a result of trauma, as well as in the enamel of patients who often grind their teeth at night.
Enamel Fracture
It is among the simple fractures. In these cases, 6-month follow-up appointments can be arranged as complications that may occur in the future can be prevented by follow-up.
Enamel Dentin Fracture
They are among simple fractures. In most cases, restoration of the fracture site is sufficient. However, the trauma caused by the trauma to the root of the tooth may cause sensitivities and pulp inflammation during the follow-up period. For this reason, it should be followed up at 3-6-12 months. Treatment options vary depending on the amount of pulp tissue and the amount of opened pulp tissue. Amputation, apexogenesis, apexification, root canal treatment and restorative procedures are among the treatments that can be applied.
Root Fractures
Depending on the root area covered by the fracture and the direction of the fracture, extraction, orthodontic or surgical extrusion + root canal treatment, intracanal post and crown treatments can be applied. In recent years, studies have been published that allow the tooth to remain in the mouth with root canal treatment and concomitant use of MTA in this type of fracture. It is a type of trauma that causes the rupture of all connective tissues. In this case, the patient should apply to a dental clinic as soon as possible by putting them in serum or a glass of milk in order to keep the tissues on the root surface moist. Following the operation, the tooth is reimplanted and splinted to the adjacent teeth. Early reimplantable teeth with incomplete root development (in the first 45 minutes or in the first 24 hours under proper storage conditions) are followed up due to the possibility of regaining vitality. If the late reimplanted teeth have not completed their root development, their root development can be completed with apexification treatment. Root canal treatment is applied after a while after reimplantation of avulsed teeth that have completed their root development.
Teeth reimplanted by the dentist should be splinted to adjacent teeth and followed with splints for 2-4 weeks. At the end of 4 weeks, the splint should be removed and checked for root resorption at 3-6-12 months. is defined. The embedding of the tooth in the socket is defined as intrusion. In both cases, the treatment approach is the same; After the tooth is repositioned to its original position and stabilized by splinting, follow-up is performed for at least 6 months with 3-6 week control sessions. Root canal treatment can be started if necessary. These teeth should be followed up in terms of root resorption at 3-6-12 months.
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