RU2494701C1 - Method of treating corono-radicular fractures of multi-rooted teeth of lower jaw - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to dentistry, and is intended for treatment of corono-radicular fractures of multi-rooted teeth of lower jaw. After final preparation of carious cavity, multi-rooted tooth is divided into two fragments by widening fracture crack to 3-4 mm. Reconstruction of crown parts of multi-rooted tooth divided into two single-rooted teeth is performed by means of constructions with intra-canal posts. Bridge prosthesis is made and fixed on both divided fragments.

EFFECT: method makes it possible to eliminate possibility of development of inflammatory complications in treatment of corono-radicular fractures of multi-rooted teeth due to division of multi-rooted tooth into two single-rooted teeth with further manufacturing of bridge prosthesis for both divided fragments.

2 ex, 2 cl

Description

The invention relates to medicine, namely to dentistry, and can be used in the treatment of coronary-radicular fractures of multirooted teeth of the lower jaw.

Known methods of treating tooth fractures, which include fixing fragments, antiseptic processing, filling and in the manufacture of crowns (RF patent No. 2133311, IPC АС 13/30, publ. 12/20/1998. And RF patent No. 2376954 for IPC А61С 5/00 from 12/27/09.)

The closest in technical essence is the method of treatment of coronary radicular fractures, which consists in antiseptic treatment after temporary fixation of fragments, endodontic treatment with the final preparation of the cavity, then weaken the temporary fixation of fragments to widen the gap to 1.0-1.5 mm between fragments with their subsequent compression after filling the resulting gap, strengthen the fixation of fragments, which are removed before installing an artificial crown for permanent fixation. (see RF patent No. 2376954 for IPC А61С 5/00 dated 12/27/09.)

A common disadvantage of methods of treating coronary-radicular fractures is that using the known method it is impossible to provide optimal conditions for filling a fracture gap due to micro-leakage of gingival fluid and blood to the edges of the fragments, leading to the additional introduction of infection and fluid into the fracture area and cavity of the tooth, which sharply worsens the adhesion conditions of the filling material to the tooth tissues, creates the conditions for further tooth decay, leads to the development of chronic inflammatory conditions timetotal and their complications in periodontal and adverse outcomes.

The invention is based on the technical task of creating a universal method for the simple and highly effective treatment of coronary-radicular fractures of multirooted teeth of the lower jaw, to eliminate the possibility of developing inflammatory complications and to provide a long-term favorable treatment result.

The task to achieve a technical result is solved by the fact that in the method of treating coronal-radicular fractures of multirooted teeth of the lower jaw, which consists in antiseptic processing, temporary and permanent fixation of fragments of fragments, endodontic treatment with the final preparation of the cavity, filling and manufacturing of an artificial crown, according to the invention, the fixation of broken fragments is not carried out, and with the final preparation of the carious cavity and its antiseptic processing ki, the fracture gap is expanded by boron to 3-4 mm, thus forming two single-root teeth from one multi-root tooth with the subsequent restoration of the crown parts of the divided tooth using intracanal pins and filling materials or pin structures and further manufacturing and fixing the bridge to both divided fragments .

The implementation of the method and its effectiveness are presented in the following clinical examples.

коронки, линия перелома проходит в вестибуло-оральном направлении. Определяется подвижность стенок 1-II степени, боли при перкуссии.Clinical example 1. A 34-year-old patient complained of pain and mobility of 4.7 teeth, which she associates with eating solid food a day ago. The patient refuses to remove, insists on maintaining the tooth. An objective examination: the carious cavity on the chewing surface on $$\raisebox{1ex}{$\mathrm{one}$}\!\left/ \!\raisebox{-1ex}{$2$}\right.$$

crowns, the fracture line runs in the vestibulo-oral direction. The mobility of the walls of the 1st-2nd degree, pain during percussion is determined.

On the radiograph 4.7, the channels are sealed evenly to the apex, the periodontal gap is slightly widened. In the area of furcation there is a resorption of up to 1-2 mm. Diagnosis: "Transverse fracture of 4.7 tooth, chronic fibrous periodontitis."

Treatment: under the infiltration anesthesia with a lidocaine solution of 2% - 1.0 ml, a carious cavity was prepared with a fracture gap widening up to 3 mm, standard metal pins were inserted and fixed on the “Core-Max” into the channels of the medial and distal fragments 4.7 of the tooth, restoration of the coronal part of each fragment “ Core Mach. " The next day, a bridge was made and fixed in the form of a ceramic-metal crown. Examination of the patient on the next day, month and year and 5 years showed the absence of any pathological changes in the gum and periodontal 4.7. Tooth mobility was not determined, percussion was painless, radiography data - periodontal gap was not expanded, electrothermometry of the gums was normal - 35.6 ° C. Aesthetic and chewing function of the tooth is restored in full.

Clinical example 2. A patient, 27 years old, applied for the preservation of 3.6 tooth in connection with his fracture. From the anamnesis of the disease it was found that pain and mobility appeared after the preparation and endodontic treatment of a tooth by a dentist. On examination, a fracture gap and mobility of fragments of the 2nd degree, pain during percussion were found. On the roentgenogram, the channels are sealed uniformly throughout, a slight expansion of the periodontal gap in the region of the apex of the root is noted. Diagnosis: "Transverse fracture 36, chronic fibrous periodontitis 36."

Treatment: Infiltration Anesthesia Sol. Lidocaini - 2% - 1.0 ml, a carious cavity was prepared with an expansion of the fracture gap up to 3 mm, standard metal pins were inserted and fixed on the Miracle-Mix into the channels of the medial and distal fragments 3.6 of the tooth, restoration of the crown part of each fragment of the Miracle-Mix ". The next day, a bridge was made and fixed in the form of a ceramic-metal crown.

Examination of the patient on the next day, month and year and 3 years showed the absence of any pathological changes in the gum and periodontal area 3.6. Tooth mobility was not determined, percussion was painless, targeted radiography data - periodontal gap was not expanded, gum electrothermometry was normal at -35.6 ° C. Aesthetic and chewing function of the tooth is restored in full.

The proposed method for the treatment of tooth fractures is a simple and highly effective treatment of coronary-radicular fractures of multirooted teeth of the lower jaw. The method allows to prevent the possibility of the development of inflammatory diseases such as marginal chronic granulating periodontitis, the development of bone resorption in the field of root furcations, purulent inflammatory processes in the form of periodontal abscess and periostitis, to ensure a long-term favorable treatment result.

Claims (2)

1. A method of treating coronary-radicular fractures of multi-rooted teeth of the lower jaw, which consists in antiseptic processing, temporary and permanent fixation of fragments of fragments, endodontic treatment with the final preparation of the cavity, filling, characterized in that after the final preparation of the cavity in the multi-root tooth by expanding the fracture gap divided into two fragments, restore the crown parts of the divided multi-root tooth into two single-root teeth using constructions with intracanal pins and the subsequent manufacture of a bridge to single-rooted teeth obtained by dividing a multi-rooted tooth into two fragments. 2. The treatment method according to claim 1, characterized in that the expansion of the fracture gap of a multi-root tooth is carried out up to 3-4 mm, forming two fragments in the form of two single-root teeth.