[On the problems of endodontal splinting of fractured tooth roots].
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Researching the actual condition of tooth fractures, clinical records and X-ray photographs of 2717 patients, visited P.D.I. Dental Clinic from November, 1986 to September, 1988 were investigated statistically. 174 cases were tooth fractures in 2717 patients. The frequency rate of tooth fractures at an early age was low, increased from the latter half of the 30s and was highest at the latter half of the 50s accounted for over 10%, and decreased from the 60s. In the upper anterior teeth, the crown fractures caused by traumatic factors, at an early age showed a high proportion, and in the lower anterior the tooth fractures were rare. In the posterior the root fractures of non-vital teeth attributed to dental treatment at the middle and advanced age indicated a high proportion. In the case of tooth restored with metalcore and bridge, the proportion of the root fractures were high, the metalcore, was used in 63%, and in the bridge in 27% of the root fractures.
Reattaching fractured tooth segments offers an esthetic transitional restorative alternative to bonded composite and full crowns. The authors review this technique and demonstrate its application.
Anterior tooth fractures can be restored utilizing treatment modalities from various dental specialties. The combination of rising patient aesthetic expectations and the desire for conservative dentistry, however, has resulted in the development of intricate direct composite layering techniques. These procedures preserve the natural tooth structure while allowing light and color to be manipulated in the restored dentition. By highlighting the importance of light, color, and material selection, this case presentation documents the use of a direct composite resin technique for the fabrication of aesthetic anterior restorations.
Signs and symptoms of the incompletely fractured tooth have been presented with emphasis on the role of occlusion in etiology and diagnosis. Early recognition and treatment are paramount.
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BACKGROUND: The author presents an evidence-based protocol for the diagnosis and treatment of incomplete tooth fractures. It is designed to help dentists recognize fractures, distinguish between restorable and nonrestorable fractures, and follow a rational approach to treatment. OVERVIEW: An incomplete tooth fracture is a frequently encountered problem that dentists need to assess carefully to arrive at the correct treatment decision. The author presents a review of representative literature corroborating the assertions made in the evidence-based protocol. Treatment approaches are presented for each of two major fracture types. CLINICAL IMPLICATIONS: Dentists need to be aware of the classic symptoms of incomplete tooth fracture, the methods used in formulating a differential diagnosis, criteria for determining pulpal status and restorability, iatrogenic factors involved in the etiology of incomplete fracture, and the consequences of inadequate diagnosis or treatment.
Intra-alveolar root fractures are relatively uncommon, and sometimes may be healed without treatment. Diagnosis of intra-alveolar root fracture is frequently made by exclusion of clinical signs of other traumatic injury, and by radiographic examination with films taken at different tube angulations. This case report presents a horizontal root fractured tooth that was healed satisfactory without treatment and moved orthodontically after prolonged time from trauma.
The incidence, causes and methods of investigating tooth fracture are reviewed. This is a problem of increasing clinical significance, with many predisposing factors. Large restorations and extensive carious lesions tend to be associated with most fractures, with fracture incidence being higher in first permanent molars than other tooth types, especially in the lower jaw. Tooth anatomy influences fracture incidence, as does the functional force applied to cusps. Fracture risk in restored teeth may be reduced by cuspal coverage. Traditional tooth fracture investigations using destructive techniques provide valuable information; however, replica and nondestructive techniques are also of value.
The influence of tooth fractures on growth of rat incisors was examined with soft X-ray radiography, xeroradiography and microradiography. Thirty young rats were used in this study and experimental fractures were produced on the mandibular left incisors. Radiological observations were carried out immediately, 7, 14, 21, 28 and 35 days after fracturing. The soft X-ray radiograms obtained immediately after fracturing showed clear radiolucent images. The radiopacity of the fractured regions gradually increased from the 7th day. Enamel hypoplasia was observed from the 7th day, and it moved towards the edge of the incisors with the growth of the fractured teeth. The xeroradiograms obtained at each term demonstrated as same findings as those obtained with soft X-ray radiography. The microradiograms obtained immediately after fracturing showed no noteworthy findings except for the clear radiolucent area of the fractured regions. Fine radiopaque lines along the edges of fractured regions were observed from the 7th day. Dentin-like radiopaque calcified masses were observed from the 14th day.
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