Dental trauma in East Paris
Maxillofacial surgery Pr Meningaud
Dental contusion
Caused by shock, they require monitoring of pulp vitality with percussion, heat and cold, the risk being mortification.
Dental subluxation
Caused by impact, the tooth is most often impacted backwards, with tooth mobility.
Treatment:
Under local anaesthetic, the stomatologist reduces the subluxation. There are several ways of restraining the subluxation. The most classic is the cradle ligature: a metal arch is secured to the adjacent teeth with steel wires, and the tooth is held to this arch with a “cradle” ligature. Another method involves taking an impression of the arch, from which a retainer plate is made. Alternatively, an archwire can be bonded to the teeth with resin, based on orthodontic principles. The period of retention varies from three to six weeks. Pulpal vitality is monitored for several months.
Dental trauma in East Paris
Maxillofacial Surgeon Paris East Créteil
Tooth dislocation
The recovered tooth should only be rinsed under water to remove any impurities deposited on it. It should not be brushed, to respect the periodontium still adhering to the root. For transport, it is kept in the athlete’s mouth, under the tongue. If this is not possible (because the patient is unconscious), the tooth is preserved in physiological saline, with penicillin if possible. Reimplantation is an emergency. Success is inversely proportional to the time required for re-implantation. Retention techniques are the same as for dental subluxations.
Dental fracture
There are several types of dental fracture. Fractures of the dental crown that do not expose the pulp chamber require prosthetic reconstruction and monitoring of pulp vitality. Fractures that expose the pulp chamber and whose fracture line respects at least the apical two-thirds of the root are suitable for pulpectomy, root canal treatment and prosthetic reconstruction. Teeth whose fracture line passes through the middle third of the root should be avulsed. Teeth whose fracture line passes through the distal third of the root are suitable for pulpectomy, root canal treatment and apical resection.