Fracture of the tooth: causes, types, symptoms, treatment

Fracture of the tooth root is one of the most difficult cases in the practice of a dentist.In this case, the trauma is not located outside, where it is well available for the use of dental instruments, but inside, which greatly complicates the diagnosis and treatment of pathology.

Fracture happens suddenly, but it often precedes the appearance of cracks on the root of the tooth.It is not easy to notice them at once, and the destruction of the root only increases with time.Through the formed lesions, penetration of pathogens takes place, which corrode bone tissue and eventually lead the tooth root to injury.

Features and localization

A fracture of the tooth, be it in the coronal part, at least in the root, is a serious injury that can cause significant damage to the dental hole, destruction of the alveolar process and even a jaw fracture.Such an injury can happen throughout the entire length of the root of the , in the most vulnerable and weakened section of it.

Dental fractures in dentistry are usually classified according to the place of their formation:

• in the coronal part, near the cervix;
• in the middle third;
• in the apical third, near the apical part of the root.

The fracture through which a fracture occurs usually passes through such parts of the root as dentin, cement and often affects the vascular bundle.In this case, if the crack managed to cause a fracture, then, most likely, it passes transversely to the growth of the tooth , and in fewer cases diagonally.

It also happens that the root begins to break down from different sides, cracks occur, and the so-called occurs as a fragmentary fracture of .

According to statistical data, the most common fractures occur between the middle and apical parts.Less often they can be found in the middle and neck of the root.And to detect such an injury at the very top about 1 to 50.

The most injury is common in the elderly , and is often found in adolescents , when the molars have already formed.Most often, the injury happens on the upper incisors.

The fractures of the coronal and root parts of the tooth on the lower incisors are much less common.Such injuries often occur with a strong horizontal impact on the incisors in the front.

A sharp force action causes a fracture, which subsequently provokes a fracture.With mechanical irritation, for example, chewing, the broken tooth is displaced, causing the root fracture to become a multiple .

This, in turn, can destroy the periodontal ligament of the tooth and its pulp.Alveolar spines can also be severely damaged.

Causes: Symptoms and Diagnosis

Fracture always occurs due to mechanical damage to the root and the appearance of a crack on it.In turn, this can happen on for a number of the most common reasons:

• improper treatment or unprofessional tooth extraction;
• direct mechanical damage, for example, shock or injury;
• a deep caries stage, which provoked a crack in the root of the tooth during physical exertion on it;
• physiological characteristics of the patient, abnormalities of tooth development, pathology of their roots.

Diagnosis of such an injury is complicated by the fact that the does not notice with a standard dental examination, since the visible coronal part of the tooth is not damaged and does not change its color.

Only in a number of cases the tooth enamel can become somewhat pink.Nevertheless, there are a number of signs that suggest a possible root fracture:

• severe pain in the gums of the damaged tooth when it palpates and chews food;
• high tooth mobility, which previously was not and its gradual loosening;
• swelling and bleeding gums;
• difficulties with opening and closing the mouth, due to damage to the pulp and the instability of the tooth.

As a rule, after the injury, the dislocation and coronal part of the tooth becomes noticeable.When you try to move the tooth with your fingers, you can feel the movement of the broken root inside the alveolar process, and thus determine the location of the fracture.

Of course, using radiography will give a more accurate result of and therefore a snapshot of the damaged tooth will be the first requirement of the attending physician.

An X-ray image will provide the necessary information about the location of the fracture, its direction, and the location of the debris, if any.In addition, the doctor learns about the degree of damage to the periodontal and how badly the bone tissue has suffered in the walls of the alveoli.

Treatment

The oblique and comminuted root fractures are the most inconvenient from the point of view of surgical intervention, since it is impossible to use the remaining root in the alveoli as a support for mounting the pin.Most often, has such a tooth to remove .In the case of a transverse fracture, the complexity of treatment depends on its localization at the root.

If the fracture is located in the middle and closer to the upper part of the root, the cavity of the tooth is opened, it is depulled, its channels are sealed, and the root remains are fastened with pins.

If the fracture happened in the immediate vicinity near the apex of the root, then a simple canal filling will suffice, since the apical part will no longer possess any significant mobility.

. In treatment, it is important not only to seal the channels and restore the crown, but also to correct the direction of growth of the teeth in order to restore the correct bite and neutralize possible damage to the gums when closing and openingJaws.

As one of the categories that is most susceptible to the occurrence of such injuries are older children, such tooth damage is often not associated with other facial injuries, but are pathologies originated independently and having their differences in the diagnosis and subsequent treatment of , Which can complicate the treatment of root fracture of the tooth.

In connection with the popularization of contact sports among children, the probability of fracture of the front teeth in the coronal or root part significantly increases, especially in the case of the upper anterior incisors.

The number of cases when the fracture is complicated by the appearance of the odontogenic jaw cyst as a result of the development of inflammatory processes is also increasing.