[Clinical results from the treatment of tooth fractures in permanent teeth by formation of troughs on the fractured tooth surfaces].
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While the awareness of vertical tooth fractures, whether incomplete or complete, is increasing, sufficient attention has not been paid to the manner in which the dentist may contribute to the occurrence of these fractures. This paper focuses on the most likely areas in which the practitioner can either misdiagnose the presence of a fractured tooth or where dental procedures contribute to fracture of the tooth structure. For this type of fracture the authors propose the term 'odontiatrogenic tooth fracture'.
About 185 tooth fracture cases among 184 patients,it was found that tooth fracture happened on misticatory occlusion almost follows the regulation at the same tooth which has suffered of damage,such as dental caries,wedge shaped defect and cracked tooth and so on.The position of tooth damage is that of tooth fracture as well.The range and extent effect obviously on the tooth fracture.The terminal point of fracture line is related closely to pulp condition.It's considered that the out force is the major direct cause of tooth fracture,while position,extent,range and pulp condition before fracture is the main inner inducement fact.
Placing crowns to prevent tooth fracture is thought to be a common but infrequently documented treatment procedure. Two studies are described that provide information about dentists' use of crowns to prevent tooth fracture. North Carolina general dentists indicated that 44% of the crowns they placed were for the principal reason of fracture prevention. However, when groups of dentists examined the same patients, there was little agreement about which teeth should be crowned due to risk of fracture. These results suggest that the placing of crowns to prevent fracture merits a careful determination of effectiveness and appropriateness.
The authors studied all tooth fractures identified within a two-week period among adult enrollees in a dental health maintenance organization to determine the incidence and severity of this condition. They found complete fracture rates of 5.0 and 4.4 per 100 adults per year for all teeth and for posterior teeth, respectively, with 15 percent of fractures resulting in pulpal involvement or extraction. These estimates, the first to be reported, provide information that is potentially useful to patients and dentists making decisions about treatment intended to prevent tooth fracture.
Increasing awareness of tooth fracture, both complete and incomplete, as a significant disease entity has led to improved diagnostic techniques. By using compact, easily handled, fiber optic instruments for transillumination and by developing a "predisposition index" to assist in the evaluation of fracture potential, new dimensions have been added in treatment planning, especially for older patients. Prevention of tooth fracture can best be accomplished by utilizing conservative, nontraumatic tooth preparation procedures, understanding predisposing factors, and using full occlusal coverage, circumferentially retained restorations whenever castings are indicated. Effective management of incomplete tooth fracture involves early recognition of the problem, appropriate and timely treatment, and a realistic assessment of the prognosis.
STATEMENT OF PROBLEM: There is much controversy in the literature relating the incidence of tooth fracture to patient age. The nature (complete or incomplete) of fracture is one aspect that is frequently reported; however, the results highlight relative differences with respect to age and the inadequacy of the statistic used for analysis. PURPOSE: This study: (1) reviewed the existing literature on the relationship of patient age and nature of tooth fracture, (2) investigated the nature of tooth fractures among attendees of an emergency clinic, and (3) assessed any relationship between nature of fracture and patient age. MATERIAL AND METHOD: From the existing literature, 6 studies were suitable for combined analysis. The study was conducted among subjects attending the Student Emergency Dental Service in the University Dental Hospital of Manchester over a 2-year period, 1995-97. Each study subject had a fractured tooth and was examined by 1 of the authors and data were recorded. RESULTS: Combined analysis showed that the age of patients with incomplete fractures was higher than those with complete fractures (P <.05). A total of 229 patients exhibited complete (n = 263) or incomplete (n = 8) fractures of 271 teeth. Age range of 18 to 47 years demonstrated a skewed distribution with a median of 21 years. There was a statistically significant difference in age distribution between the 2 natures of tooth fracture (P <.05) with incomplete fractures associated with older ages. CONCLUSION: Incomplete tooth fractures are uncommon in students attending an emergency clinic. Complete fractures may occur at any age, while it appears that incomplete fractures are associated with older age groups.
Root fracture is one of the consequences of dental traumatisms. The possibility of saving the fractured tooth depends on the level of the fracture and also on pulp vitality. This case report describes the use of MTA in association to an intracanal post to reinforce a maxillary central incisor with horizontal root fracture in its cervical third.
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