Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2016-11-22, 09:52:12 | version 1.38.0
| CE article traumatic dental injuries 16 roots 4 2016 The treatment of traumatic dental injuries Author: Dr Asgeir Sigurdsson, USA Introduction Whentreatingdentaltrauma,thetimelinessofcare iskeytosavingthetoothinmanycases.Itis,therefore, importantforalldentiststohaveanunderstandingof how to diagnose and treat the most common dental injuries. This is especially critical in the emergency phase of treatment. Propermanagementofdentaltraumaismostoften ateameffortwithgeneraldentists,pediatricdentists or oral surgeons on the front line of the emergency service, and endodontic specialists joining the effort to preserve the tooth with respect to the pulp, pulpal space and root. An informed and coordinated effort from all team members ensures that the patient re- ceives the most efficient and effective care. Recently, a panel of expert members of the Amer- ican Association of Endodontists prepared an up- dated version of Guidelines for the Treatment of Traumatic Dental Injuries.1, 2 These guidelines were based, in part, on the current recommendations of the International Association of Dental Traumatol- ogy (see www.iadtdentaltrauma.org for more infor- mation).ThisarticleprovidesanoverviewoftheAAE guidelines;thecompleteguidelinesareavailablefor free download at www.aae.org/clinical-resources/ trauma-resources.aspx. Thebenefitofadheringtoguidelinesfortreatment ofdentaltraumawasrecentlyshowninastudybyBu- cheretal.3 Thestudyfoundthat,comparedwithcases treated without compliance to guidelines, cases that adhered to guidelines produced more favorable out- comes, including significantly lower complication rates.Thestudyalsofoundthatearlyfollow-upvisits were essential to ensure prompt treatment of com- plications when they arose.3 Emergency care Priortoanytreatment,onemustevaluatetheinjury thoroughlybycarefulclinicalandradiographicinves- tigation. It is recommended to follow a check list to ensure that all necessary information regarding the patient and the injury is gathered, including: 1. Patient’s name, age, sex, address and contact numbers (include weight for young patients). 2. Centralnervoussystemsymptomsexhibitedafter the injury. 3. Patient’s general health. 4. When, where and how the injury occurred. 5. Treatment the patient received elsewhere. 6. History of previous dental injuries. 7. Disturbances in the bite. 8. Tooth reactions to thermal changes or sensitivity to sweet/sour. 9. If the teeth are sore to touch or during eating. 10. Ifthepatientisexperiencingspontaneouspainin the teeth. Once all of this information is gathered, a diagnosis can be made and appropriate treatment rendered. If theinjuredindividualisnotapatientofrecord,allnec- essary demographic information should be gathered as soon as the patient arrives and prior to any assess- ment.Inthecaseofavulsionandthetoothbeingoutof CE credit This article qualifies for CE credit. To take the CE quiz,log on to www. dtstudyclub.com. Click on ‘CE arti- cles’ and search for this edition of roots magazine. If you are not reg- istered with the site, you will be asked to do so before taking the quiz. Fig.1a: Clinical case of two uncomplicated crown fractures in which the two broken pieces were located and reattached.(Photos: Provided byAmericanAssociation of Endodontists) Figs.1b & c:After the two pieces had been attached,a chamfer was cut along the fracture line and additional composite cured in place.This will both increase the strength of the attachment and better hide the fracture line. Fig.1a Fig.1b Fig.1c 42016