Dislocation of a baby tooth in a child treatment. Dislocation of a milk tooth: treatment of a thrust-in dislocation of a milk tooth in a child. Is it possible to prevent such an injury?

Injury to teeth in children is a fairly common and typical injury from falling on the face, hitting the face with hard objects, or hitting the face with a hard object. Most often, the upper incisors are injured, then the lower incisors, rarely - premolars (4, 5 teeth) and molars (6, 7, 8 teeth).

The most common type of injury is dislocation of deciduous teeth, chipped crowns (without opening the tooth cavity) and dislocation of permanent teeth. Fracture of the roots of teeth is rare (milk - practically does not occur).

Classification of dental injuries:

1. Tooth contusion.

2. Traumatic dystopia of the tooth (incomplete dislocation):

vertically (impacted dislocation);

sagittal;

transversal.

3. Loss of a tooth (complete dislocation, extraction).

4. Violation of the integrity of the tooth:

fracture of the crown;

root fracture (oblique, longitudinal, transverse).

5. Combined injury.

Tooth contusion

Tooth contusion is a mechanical effect on a tooth without damaging its integrity. With a bruised tooth, hemorrhage into the pulp is possible due to rupture of the neurovascular bundle. At the same time, the bite practically never changes.

Clinical picture

Immediately after the injury and for some time after it, the child may complain of slight pain in the tooth when biting.

On examination, insignificant mobility of the injured tooth in one direction can be detected, painful percussion (tapping), no changes in the surrounding tissues and the tooth are noted. Surgical treatment is not indicated in this case.

The state of the pulp should be further evaluated according to the data of electrodontodiagnostics (EDI), taking into account whether these are temporary or permanent teeth, permanent with a formed or with an unformed root. EDI is performed 1, 3 and 6 months after injury in a polyclinic. If, over time, an increase in the EDI indices can be traced, which indicates the death of the pulp, it is necessary to carry out endodontic treatment - depulpation of the tooth with its filling and filling of its canal, if the tooth is permanent).

Tooth contusion should be distinguished from:

a) incomplete traumatic dystopia (in this case, the mobility of the tooth is possible in several directions, on the roentgenogram - the expansion of the periodontal gap):

b) root fracture (X-ray picture is characterized by a violation of its integrity):

c) intrapulpal granuloma, in which a pink color of the tooth crown is observed on one of its surfaces.

Treatment

Treatment of a bruised tooth consists in ensuring rest, excluding it from the bite, adhering to a mechanically sparing diet. If necessary, anti-inflammatory treatment is carried out.

If the death of the pulp in permanent teeth is determined clinically and according to the EDI data, it should be removed and the canal filling, and in temporary, depending on the condition of the root, the tooth should be treated or extracted.

As a result of a tooth contusion, various outcomes are possible:

restoration of pulp function;

the death of the pulp;

canal obliteration;

the development of post-traumatic periodontitis;

the development of a radicular cyst;

cessation of root formation in a permanent or temporary tooth.

Traumatic tooth dystopia (dislocation)

In the conventional sense, the word "dislocation" means a persistent displacement of the articular surfaces of the articulated bones beyond their physiological mobility, causing dysfunction of the joint. The tooth and its connection with the socket do not form a joint, because there are no joint components: articular surfaces, articular cavity and synovial fluid, therefore there can be no dislocation. Based on the anatomical relationship of the tooth and the hole, one should talk about its traumatic dystopia. The concept of "dislocation of a tooth" is conditional here, as well as a dislocation of the eye, lens, tendon, nerve, testicle, nevertheless, this concept has firmly taken root in medical practice and lexicon.

Traumatic dystopia (incomplete dislocation) of the tooth is a displacement of the tooth relative to the hole due to rupture or stretching of the periodontal ligaments and trauma to the root of the tooth of the walls of the hole. In this case, the position of the tooth changes in one of three directions: vertically (its exit or immersion into the bone tissue of the alveolar process; rotation around the longitudinal axis), along the sagittal (displacement in the anteroposterior direction), transversally (lateral displacement, to the side adjacent teeth).

Complaints

The presence of a movable tooth, a change in its position (increase in height; rotation of the tooth; displacement of the crown outward or inward), changes in bite after injury.

Clinical picture

Traumatic dystopia of the tooth is characterized by its increased mobility, a change in its usual position. When the tooth leaves the hole, its cutting edge protrudes above the occlusal plane (the plane of teeth closing) - above the cutting edge of other teeth. In the event of a traumatic rotation of the tooth, it can take a position at an angle around the longitudinal axis. As a result of such movements of the teeth, the bite is usually disturbed. In this case, the lower jaw often acquires a forced position, since the child shifts it to a position in which the dislocated tooth does not come into contact with the opposing tooth on the other jaw. In addition, there is pain in the tooth when biting. Often this is accompanied by edema of the tissues of the lip, gums, sometimes there may be slight bleeding from the periodontal gap, which indicates an injury to the neurovascular bundle. With traumatic dystopia of the tooth, the bundle is often stretched, but not torn, that is, the pulp is functioning. Percussion of the injured tooth is painful. On the roentgenogram, the expansion of the periodontal gap is determined (uniform or uneven).

With the impacted dislocation (immersion of the tooth into the bone tissue of the alveolar process), there may be swelling of the lip. In the oral cavity - swelling of the gums, bleeding from them; the tooth is not in place or part of its crown is visible with a decrease in its height compared to that of the adjacent teeth. Percussion of the injured tooth is painful. Sometimes, palpation of the alveolar ridge under the gum reveals a part of the tooth crown. If the diagnosis is unclear and it is difficult to establish it during examination, an X-ray of the alveolar process in the injured area is performed. On the roentgenogram - the cutting edge of the crown of the injured tooth of the upper jaw is located above (on the lower jaw - below) the adjacent teeth. Areas of the normal periodontal gap and the shadow of the root without it (in the place of hammering) are traced. If the impact force was large and the tooth went beyond the hole, then it can be found in the jaw, maxillary sinus or in soft tissues.

Differential diagnosis is carried out with: fracture of the alveolar bone; the position of the teeth with diastema (treme) during the formation of the bite; movement of the tooth in case of periodontal disease; anomaly in the position of the tooth; fracture of the crown.

Treatment

In case of traumatic dystopia of a permanent tooth with displacement under local or general (depending on the extent of injury, age and behavior of the child), the displaced tooth is set in the correct position (reposition) and fixed (immobilization) with anesthesia.

Fixation can be carried out using:

wire ligatures that fix a tooth to adjacent teeth;

wire ligatures on a metal brace (which is fixed to the adjacent 2-4 teeth, and a dislocated tooth to it);

splints-mouthguards (made of fast-hardening plastic), fixing the injured and adjacent 2-3 teeth;

tires made of filling material, etc.

The choice of material depends on the nature and extent of the injury, on what kind of tooth it is, on the degree of eruption of adjacent teeth, on the age of the child.

Dislocated milk teeth are practically not subject to reposition and immobilization and are usually removed. An exception is a hammered dislocation, in which the tooth must be left in place, since in the future its growth can continue with the restoration of the position of the tooth (up to the age of 2 years). In the absence of restoration of the position of the tooth, an orthodontist consultation is indicated regarding the need to restore the position of the tooth or, more often, removal. However, if post-traumatic inflammation (periodontitis) occurs as a result of the impacted dislocation of the milk tooth, the tooth must definitely be removed. The defect remaining after tooth extraction can be replaced with a functional-cosmetic removable prosthesis for a while until the permanent tooth erupts.

When a permanent tooth is dislocated, it is also usually left in place (if it is displaced within the alveolar ridge). In the future, an orthodontist's consultation is shown to resolve the issue of restoring the position of the tooth.

Subsequently, the child should be under the supervision of an orthodontist (to prevent deformities of the dentition) and a dentist-therapist, who conducts a control EDI of the injured tooth to detect possible death of the pulp or changes in the periodontal tissues. If the EDI indicators indicate the death of the pulp, then it is necessary to remove it and fill the tooth canal.

Incomplete dislocation of a tooth can damage the neurovascular bundle of this tooth; development of periodontitis and periostitis, cessation of root formation in a permanent or temporary tooth; fusion of the tooth with the remnants of the periodontium in the wrong position; defects and deformations of the dentition.

Complete dislocation of the tooth

With this type of injury, the tooth completely loses its connection with the hole and soft tissues (there is a rupture of the tissues of the periodontal, circular ligament, neurovascular bundle). More often during trauma, the central upper incisors are dislocated.

Typical complaints are pain in the area of ​​the injured alveolar ridge, edema of the lip, bleeding from the area of ​​injury and the absence of a tooth. Sometimes patients bring a dislocated tooth with them.

Clinical picture

When examining the site of damage, the absence of a tooth is revealed, there may be moderate bleeding from the hole, damage to the soft tissues of the alveolar process is possible.

X-rays show the absence of a tooth both in the hole and in the surrounding tissues.

It is necessary to make sure that this is not a punctured dislocation or a fracture of the tooth in the root area.

Treatment

In case of complete dislocation, replantation of the tooth is carried out (permanent teeth with a root formed at least half the length). In all other cases, replantation is not carried out, and after 1-2 months, the missing tooth is replaced with a prosthesis. The issue of replantation of a milk tooth with a formed root that has not begun to dissolve is controversial and complex, since the reliability of tooth fixation strongly depends on the condition of the adjacent teeth.

The stages of replantation are as follows: under local or general anesthesia, a thorough curettage of the hole is performed - a clot, small bone fragments, foreign bodies are removed, the hole is treated with antiseptics and necessarily cause bleeding from the walls of the hole (that is, the hole should not be "dry"). In the future, the doctor chooses a therapeutic tactic regarding the pulp of a dislocated tooth. The approximate time elapsed from the moment of tooth loss to its replantation, when it is possible to do without filling the canal, is 6-12 hours. Experience shows that the pulp does not die during these periods. In case of remote replantation, when more than 12 hours have passed since the injury, the pulp is removed and the tooth canal is filled. Then the tooth is placed in the socket and fixed.

Anti-inflammatory (antibacterial) therapy is mandatory. Observance of oral hygiene is of particular importance in the process of tooth engraftment.

Possible consequences of complete dislocation of the tooth in the absence of treatment may be the occurrence of inflammatory processes in soft tissues and bones; dentition defect.

Fracture of the crown of the tooth (chip)

Distinguish between enamel chipping, crown chipping within dentin, and chipping of the entire crown.

Complaints

When the tooth enamel and crown are chipped within the dentin boundaries, children complain only about the presence of a defect in the tooth crown, the pulp is often not affected. In case of a fracture of a tooth within the dentin or the entire crown, complaints of pain when eating hot or cold food or a sharp edge scratching the tongue or mucous membrane of the lip or cheek.

Clinical picture

There is a violation of the integrity of the tooth crown within the enamel and dentin (sometimes with the opening of the tooth cavity) or almost complete absence of the crown. Increased tooth mobility is rare or insignificant. Percussion is sometimes painful. On the roentgenogram, the defect of the crown is determined within the boundaries of the enamel and dentin, there is a layer of dentin above the pulp chamber (with an unopened tooth cavity) or it is absent (with an open tooth cavity).

Treatment

In case of a fracture of the crown within the enamel (chipping), the sharp edges are ground and the surface is coated with fluoride varnish or other remineralizing agent, the tooth is provided with rest by "excluding" it from the bite. Subsequently, the defect of the tooth crown is eliminated with filling materials.

When the tooth crown is chipped within the enamel and dentin without opening the pulp chamber, a protective filling and a protective crown are applied to the cleavage site. After 1-2 weeks, when a sufficient amount of new dentin is formed, after the control EDI, the crown is restored with filling materials.

In case of fractures of the tooth crown with the opening of the pulp chamber, if 24 hours have passed after the injury, the pulp is removed, followed by the filling of the canal and the elimination of the defect in the crown of the tooth. If the injury to the tooth was received no later than 24 hours from the moment of treatment, it is possible to preserve the pulp with the protection of the crown of the tooth and the subsequent elimination of the defect with filling materials. Children with a fracture of the crown of the tooth are under dispensary observation until the complete formation of the root of the tooth.

In case of a complete fracture of the tooth crown, the canal is filled and subsequently the crown is restored with a pin tooth in the case of a permanent tooth with a root formed or formed by two-thirds or without a pin with filling materials.

Tooth root fracture

As a rule, the roots of the permanent incisors break more often. Fractures of the roots of deciduous teeth are very rare, due to the peculiarities of the anatomy of the deciduous tooth and the alveolar process in younger children.

Fracture of the root of a permanent tooth can be oblique, longitudinal, splinter and combined.

Complaints

The child usually complains of pain when biting, tooth mobility, swelling of the gums in the area of ​​the injured tooth.

The clinical picture of fractures of the tooth root is poor and depends on the level of the fracture, the degree of displacement of the fragments, damage to the pulp. There may be slight mobility, painful percussion and pressure on the tooth.

The final diagnosis is made after a targeted X-ray of the tooth. On the roentgenogram, the location of the fracture of the tooth root is determined.

Treatment

In the overwhelming majority of cases, with a fracture of the root of a deciduous tooth, the tooth must be removed.

In case of a fracture of the root apex in a permanent tooth and the subsequent occurrence of periodontitis, the root apex must be removed after filling the canal and eliminating inflammation. If there is no inflammation, then the apex is not removed.

In case of a fracture of the root of a permanent tooth in its middle part, if the pulp has died, the canal is sealed and a pin crown is made. In those cases when the pulp does not die, the tooth is provided with rest by turning it off from the bite. Over the next 6 months, the child is under the supervision of a dentist-therapist, who monitors the EDI of the tooth and, if necessary, carries out its treatment.

A longitudinal (vertical) fracture of a tooth, like a comminuted one, is an absolute indication for tooth extraction.

Combined injury

It is characterized by a combination of several types of tooth damage:

displacement of the tooth in two or more directions with dislocation;

dislocation of a tooth with a fracture of the crown;

dislocated tooth with root fracture;

impacted tooth dislocation with crown fracture;

impacted tooth dislocation with root fracture;

complete dislocation of the tooth in combination with a fracture of the crown or root, etc.

Treatment is carried out depending on the type of injury.

Some authors distinguish the following types of dental trauma: contusions, subluxations and partial or complete dislocations. There is no consensus regarding the differences between these terms. Different authors use different definitions. Below, the terms contusion, incomplete dislocation and complete dislocation will be used, since they are adequate for clinical differentiation and treatment of traumatic injuries.

Contusion is damage to the tooth and its fixing apparatus without displacement of its position in the alveolus. The most noticeable clinical manifestation of contusion is a significantly increased sensitivity to percussion. Although no apparent displacement is observed, mobility may occur.

Incomplete dislocation is an injury in which a tooth is displaced from its position in the socket. If there is any change in the usual position of the tooth in the socket, this condition is considered a partial dislocation.

A complete dislocation is a complete loss of a tooth from a hole.

Traumatic damage to the tooth is most likely to cause obstruction of the main pulp vessels in the apex. Subsequently, there is a release of blood with the expansion of the capillaries of the pulp. After stagnation in the capillaries, their degeneration occurs with the release of erythrocytes and pulp edema. Due to the lack of collaterals in the pulp, only a small inflammatory response to injury develops and partial or complete pulp infarction may occur. With little or no blood flow, the pulp can remain in this state for many months or years. With transient bacteremia, microbes can penetrate through the small vessels of the root apex into the infarcted pulp tissue and settle in it.

The resulting infection may be the first clinical sign of pulp necrosis. Stanley noted that in some cases, the heart attack is not total. Several vessels continue to function and transport fresh blood to the pulp sites. These areas will remain alive. If the pulp tests are negative, but there is sensitive tissue in the pulp cavity and bleeding from deeper sections, then the remaining blood flow supports some nerve fibers. The tissue affected by the infarction appears to block thermomechanical receptors, thus preventing the passage of stimuli received through enamel and dentin.

This means that if the trauma of the tooth and pulp is minimal, then short-term pulp ischemia can cause the development of reversible superficial infarctions. This can explain the recovery of positive pulp reactions after a few weeks.

With minimal displacement of the tooth from the socket, it will be slightly mobile and sensitive to percussion and pressure when biting. Due to damage to the periodontal ligament from the dentogingival sulcus, slight bleeding is possible. Radiographically, a thickening of the periodontal gap can be detected. Such a tooth will probably not need splinting. If there is any doubt about the need for splinting, then it must be performed.

There is evidence that the combination of mobility with other damage to the tooth significantly increases the incidence of pulp necrosis. Fractures of the crowns without bruising or the appearance of mobility cause pulp necrosis in 3% of cases. However, with bruised fractures, the incidence of necrosis increases to 30% or more.

In the presence of obvious clinical or radiological signs of tooth displacement, it is necessary to perform their reposition and splinting. With a slight displacement, endodontic treatment is usually not carried out, however, in about half of these teeth, the pulp ultimately necrotic and requires root canal treatment. Therefore, clinical observation should be continued to determine the state of the pulp.

Incomplete dislocation with significant displacement

With severe damage, the teeth undergo significant displacements from their position in the socket (more than 5 mm). These injuries can be accompanied by fractures of the alveolar bone. The diagnosis is obvious when the tooth is extruded from the socket or in vestibulo-lingual displacement.

If several teeth are damaged, such as in a car accident, they can become so displaced that their normal position is completely disturbed. It is necessary to reposition these teeth in such a way that all the teeth of the antagonists close together.

When the tooth is extruded (vertical displacement from the socket) in the apex region, a clear expansion of the periodontal gap will be determined radiographically. If the root is displaced mesially or distally, then the expansion of the space will be unilateral, on the side opposite to the displacement of the root. When the root is displaced in the vestibular or lingual direction, the enlarged space can be hidden behind the root of the tooth in its new position.

With displaced teeth, pulp temperature and electrical tests are unpredictable. The problem of the reliability of pulp tests for dental injuries has already been discussed, but in general it can be noted that the greater the displacement and mobility, the less likely the pulp will remain viable.

Treatment of impacted tooth dislocation can be different. With minimal displacement, the tooth often falls into place by itself, especially if the root is not fully formed. In case of strong displacement, the tooth must be pulled to its original position with forceps and splinted, or it should be orthodontically set to its normal position. The least complications in the form of root resorption and loss of the alveolar bone with impacted dislocation occur when the tooth is moved to its normal position orthodontically for 3 to 4 weeks.

Ankylosis may occur due to root resorption. As recent studies have shown, in experimental animals that have been exposed to intrusive forces, ankylosis is observed after 5-6 days. External orthodontic movement should be started immediately after injury in order to position the tooth in the correct position before possible ankylosis.

Another complication is pulp necrosis (observed in 96% of teeth with internal displacement). With necrosis of the pulp, the frequency of external root resorption increases. To prevent the onset of inflammatory resorption, with intrusive displacement of a fully formed tooth, endodontic treatment must be performed within 2-3 weeks from the moment of damage. Therefore, in order to have access to the root canal, the tooth must be in its place, which further justifies a quick start of orthodontic treatment, and not the expectation of spontaneous restoration of the position of the tooth, which can last several months. If the internal displacement does not interfere with the access to the pulp chamber, then spontaneous restoration of the position of the tooth can be expected.

However, it is possible to develop ankylosis, which prevents the return of the tooth to its normal position.

Complications of dislocation injuries

The main complications of displaced injuries were described by Andreasen. These are:

  • obliteration of the pulp;

    root resorption;

    loss of fixation to the marginal bone.

Pulp necrosis with dislocations occurs in 52% of cases, and with intrusive dislocations in 96%. According to various sources, the frequency of pulp necrosis during extrusion dislocations is 64-98%. It is also more likely in teeth with fully formed roots than in teeth with unformed roots.

Dystrophic pulp calcification occurs in about 20-25% of cases. It is a response to moderate damage such as minimal displacement. A dislocation with significant displacement is likely to lead to pulp necrosis. After trauma to teeth with incompletely formed roots, the likelihood of retaining a living pulp is higher, as is the likelihood of pulp obliteration. With intrusive dislocations, pulp necrosis often develops, therefore obliteration is uncommon.

Pulp necrosis after calcification develops in about 10% of injured teeth. Therefore, prophylactic extirpation of the pulp, performed after the detection of its dystrophic calcification, is not justified. A successful outcome was noted in 80% of endodontically treated teeth with symptoms of obliteration.

After intrusive displacement, root resorption is usually observed. In terms of the frequency of root resorption, this type of displacement is the second after extrusion displacement. Pulp necrosis is also common with intrusive displacement. It is believed to promote root resorption. Resorption is detected only 2 months after injury, but it can also appear after several months.

The more severe the tooth injury, the more significant the periodontal injury, especially with injuries with extrusion and intrusive displacements. Delayed tooth reduction also increases the risk of damage to the supporting periodontal tissues.

Endodontic treatment of teeth for dislocation

The decision on endodontic treatment of a tooth in case of dislocation is made taking into account the situation in each specific case. There are several factors to consider. When deciding whether to open a root canal, it is helpful to consider several factors. The main and decisive indicator is the diagnosis of pulp necrosis. It is based on sensitivity to percussion, noticeable discoloration of the tooth, lack of pulp response to thermal and electrical tests, and X-ray data. In dental injuries, the pulp response to tests is a very unreliable indicator.

In permanent teeth with formed roots in case of dislocation with a strong displacement (more than 5 mm), pulp necrosis is most likely. Therefore, root canal treatment is indicated for them, since the frequency of root resorption in such cases is especially high. To prevent the onset of root resorption, the use of calcium hydroxide is justified as a temporary root filling material.

Teeth with minimal displacement require splinting and close monitoring of the pulp state with X-ray control after 1, 3, 6 and 12 months. If the image shows periapical enlightenment or clear inflammatory resorption, then endodontic treatment should be started immediately. The presence of periapical enlightenment without inflammatory resorption in teeth with formed roots provides a basis for endodontic treatment with gutta-percha. Any signs of inflammatory root resorption justify a temporary filling with calcium hydroxide to stop it.

A displaced tooth with an unformed root has a favorable prognosis for pulp preservation. Keeping the pulp alive contributes to the normal development of the root. On the other hand, inflammatory root resorption in rooted teeth progresses more rapidly. Therefore, these teeth require careful X-ray observation. If pulp necrosis is diagnosed or there is clear periapical clearance or root resorption, endodontic treatment should be initiated immediately. Until the apex closes and root resorption stops, the canal is filled with calcium hydroxide. Later it is removed and permanent filling with gutta-percha is performed.

Dislocation of deciduous teeth

In children, due to the elasticity of the alveolar bone and shorter roots, tooth dislocations are more common than crown or root fractures.

When diagnosing dislocations of deciduous teeth, determining the angle of displacement is of decisive importance, since the roots of deciduous teeth are very close to the developing permanent teeth. A typical displaced injury results in lingual movement of the crown, while the root moves vestibularly, but the tooth remains intact. If the root of a temporary tooth is displaced vestibularly, then the probability of damage to the underlying permanent tooth is less than with its lingual displacement or intrusion. In the last two cases, the likelihood of permanent tooth damage increases significantly.

It has been noticed that hypoplasia of the enamel of permanent anterior teeth in about 10% of cases is a consequence of trauma to deciduous teeth. Enamel hypoplasia spots are white or yellow-brown. More serious injuries such as impaired crown or root development of permanent teeth and sequestration of permanent tooth buds are possible but unlikely.

Treatment of bruises and dislocations with slight displacement of deciduous teeth is limited to clinical observation and X-ray control.

With strong lateral displacements and intrusion, X-ray confirmation of the position of the root is necessary. Occlusal imaging performed for this purpose requires certain professional skills and can be useful in determining the position of the root.

There is an opinion that if the root of a temporary tooth is displaced vestibularly, the position of the tooth should be restored spontaneously. There appears to be no difference in complications for temporary and permanent teeth if given the opportunity to spontaneously recover. Moreover, when removing an injured temporary tooth, there is a possibility of damage to the permanent tooth. The restoration of the position of the displaced temporary tooth usually occurs in 1-6 months. If, during intrusion, the temporary tooth does not move back after 2-3 months, then ankylosis has probably developed and must be removed. With the development of inflammation of the periapical tissues, a temporary tooth with an internal displacement must also be removed.

If the root of a temporary tooth is displaced lingually towards the developing permanent tooth, then it must be removed. Root resorption in anterior deciduous teeth begins from the lingual surface. There is also a vestibular bending of the remainder of the root. Since in most injuries the blow is directed from the front, in case of dislocation of the frontal deciduous teeth, the crown moves lingually, and the root moves vestibularly. Consequently, the frequency of displacement of the anterior deciduous teeth towards the developing permanent teeth is rather low.

Parents and the child should be warned about the possibility of serious damage to the developing permanent tooth, which can occur when a temporary tooth is inserted into it. The likelihood of insurance problems and litigation requires careful recording of trauma data until the permanent teeth erupt and they are thoroughly examined for developmental disabilities.

There are conflicting opinions regarding the treatment of dislocation of deciduous teeth. One of them is that they should be removed. The opposite opinion, which is held by many experts, is that temporary teeth with dislocation should be preserved.

This opinion is based on the fact that endodontic treatment of deciduous teeth can be successful. If the dislocation of a temporary tooth is partial, not complete, then the tooth usually has a sufficient root length to re-anchor in the socket. Therefore, if it can be repositioned and stabilized, then it should be preserved, as permanent teeth are preserved. In our experience, the vestibular bending of the root of a temporary tooth makes it possible to put it back in its original position, often even without splinting. If the tooth is mobile, then it is advisable to install a splint made of a composite material with etching for 7-10 days.

With an open apex of the root of a temporary tooth, there is an opportunity for revascularization. Endodontic treatment should be performed only when signs of pulp necrosis appear, such as persistent percussion sensitivity, radiographic periapical illumination, or continued darkening of the tooth.

In temporary teeth with intrusive displacement, which were given the opportunity to protrude back, pulp necrosis occurs in about one third of cases. Diagnosis of pulp necrosis is based on hypersensitivity, periapical clarification and discoloration of the tooth. One study showed that a 50% gray discoloration of deciduous teeth is reversible. The gray color, due to the obliteration of the pulp, subsequently turns into yellow. Care should be taken when diagnosing pulp necrosis. Pulpal necrosis in monkeys, lasting for 6 weeks and accompanied by periapical inflammation, did not cause damage to the developing permanent tooth. If pulp necrosis of a temporary tooth is diagnosed, then in order to eliminate periapical inflammation, endodontic treatment should be immediately started according to the principles of pediatric dentistry.

It is believed that the greatest damage to the developing permanent tooth is caused by the primary impact of the temporary tooth. Therefore, if a decision is made to preserve a temporary tooth with a vestibular root displacement, then conventional endodontic treatment is justified to eliminate prolonged periapical inflammation.

Dental dislocation is a traumatic injury, through involuntary exposure, followed by a violation of the integrity of the tissue and movement of the dental crown. According to the degree of damage, they are distinguished: dislocation of the tooth is incomplete, complete and impacted.

Types of tooth dislocation: complete, incomplete, knocked together

Symptoms and causes

One of the most common injuries to the frontal facial apparatus is dental dislocation. Basically, it causes its mechanical effect on the jaw apparatus. The shift can be both vertical and horizontal. Symptoms of manifestation:

  • severe pain;
  • displacement of crowns;
  • unusual mobility.

The reason may be a blow or biting on tough food. Incisors and canines are most susceptible to dislocation with severe bruises, sudden falls. Incorrect deletion leads to dysfunctions of the nearest. If the gum is weakened or there are microcracks on the teeth, then chewing hard food or getting hard particles on the tooth: fruit pits or bone fragments in meat also lead to dislocation.

Causes of dislocated teeth in pictures

Malicious addictions, such as opening containers, gnawing nuts or seeds, will eventually lead to such consequences. All this happens either with direct injury to the crown, or with damage to the gums. Injuries such as a fracture of the root of a tooth or alveolar ridge are uncommon. With very strong exposure, even jaw dislocation is possible.

Traumatic chips without dislocation

In order for the tooth to shift in the gingival canal, considerable force is needed. With the weakening of bone tissue, dislocation of the impacted tooth can also occur under the action of solid food particles.

How to treat

If milk teeth are damaged, then procedures with pain regeneration are initially unnecessary. The dentist will almost certainly recommend removal. The main thing is not to leave crown fragments in the hole. If all procedures are performed correctly and in a timely manner, then such an injury will not be reflected in a permanent tooth that has grown in the future.

First of all, the pulp is removed, the filling is placed in the root canal and the tooth itself is set. The procedure is very painful and is therefore often performed under local anesthesia. If the patient has an acute intolerance to anesthesia, then manipulations are carried out without it or other anesthetics are selected. Then the damaged tooth is reliably strengthened and consolidated to the adjacent crowns.

With such a device, you will have to walk for about a month, or even more, depending on the degree of damage. Eating solid foods should be avoided.

It is advisable to do all the manipulations on the same day when the injury was received. After some time after the injury, you will have to undergo a full-fledged operation to further preserve the tooth.

It is important in the process of treatment to prevent and miss the process of inflammation. This probability is very high. For this, a course of antibiotics is prescribed.

If there is a complete dislocation, that is, the loss of a tooth, the replantation procedure is performed - this is the restoration of the crown in its place. This procedure is influenced by the client's age, the total condition of all incisors, the position of the tooth and gums.

Signs of impaired dislocation

Impacted incisor dislocation is a complete lag and a crack in the periodontal and upper capillary bundle. With all this, the tooth is motionless. Sometimes there is not even pain, since it is located deep in the gum in a motionless state.

When the maxillary teeth are dislocated, the crown moves into the upper jaw or nasal cavity. That is, there is a shortening, pain and bleeding of tissues, obstruction of chewing.

The damaged tooth has an irregular position in relation to the adjacent teeth. It can be turned to one side or completely submerged into the gum. The crown itself is motionless. Some soreness is noticed when biting. Swelling of the gums is observed around the injury.

Impacted dislocation - the tooth is buried

Dislocation of a milk tooth is driven in - before changing it, it implies dynamic observation, in anticipation of its natural return to its original place, because the formation of the root system is still possible in milk teeth. Such a tactic is possible with only erupted permanent teeth.

It is advisable to wait until the tooth snaps into place on its own if the dislocation is not very deep and there are no inflammation processes.

Treatment methods

Impacted dislocation is treated in three ways.

  1. The therapeutic method is to put a splint and fill the canal.
  2. Orthodontic - the tooth is put into place using special equipment.
  3. Surgical method - a damaged tooth is removed in case of severe dislocation, followed by inflammation of the gums.

In addition to the direct consequences of trauma, even an outwardly healthy tooth may experience pulp necrosis, which may ultimately lead to periodontal disease.

More serious consequences will be a root cyst, suppuration of bone tissue, osteomyelitis of the jaw.

Children's dentistry

Tooth dislocation is the most common childhood injury. Due to age characteristics, the children's jaw apparatus is often prone to damage.

Dislocations lead to displacement of the crown, and sometimes even to loss. Based on the characteristics and severity of injuries, dislocations are divided into:

  • simple;
  • impacted tooth dislocation in a child;
  • lateral dislocation with displacement;
  • full.

In case of bruises, damage to the tooth and its ligaments is observed of an insignificant nature, without mobility and displacement of the crowns. Subluxation is characterized by mobility without displacement. Damaged teeth are very sensitive, biting food causes pain, there may be a slight swelling of the gums.

Complete dislocation of a permanent tooth

Treatment of a dislocated tooth in a child

Before prescribing a course of treatment, the dentist conducts diagnostics. An X-ray of the affected tooth needs to be taken. Follow a certain diet for one week.

Impacting occurs most often among the trauma of children's teeth. The central part of the jaw apparatus often takes on the entire force of the blow. With a severe bruise, the milk teeth go so deep into the gums that they become almost invisible. With such a dislocation, it is also mandatory to take a picture of the jaw. After evaluating the whole picture, treatment is prescribed. In the case when the tooth is visible, expectant tactics are chosen without intervention. Over time, it will cut itself through. If it has sunk completely into the gum, it is highly recommended to remove it as soon as possible.

Depending on the degree of damage and looseness in lateral dislocation with displacement, remove or wait for recovery. A complete dislocation is a loss of the crown.

Signs of incomplete dislocation

Partial dislocation is characterized by the fact that the crown remains in place. Incomplete tissue rupture occurs. Also, incomplete dislocation is characterized by damage to the neurovascular bundle.

Symptoms:

  • position changed;
  • the crown becomes mobile;
  • biting even unsolid food causes pain;
  • the gum becomes inflamed and bleeds;
  • spontaneous pain sensations without any effect on the tooth.

During the diagnosis, hemorrhages of the cheeks and lips are detected. The diseased tooth is incorrectly positioned in relation to others. The inclination can be in the oral cavity or in the vestibular side, it can be rotated around the axis or stretched towards the nearby tooth. The crown itself and its root are displaced in opposite directions with incomplete dislocation.

According to clinical manifestations, this type of dislocation can be confused with a fracture of a tooth or its root.

How to distinguish?

A finger is applied to the alveolar ridge at the site of injury. Then the tooth is carefully displaced. When carrying out this manipulation, the movement of the root system is felt. If there is a fracture, then only part of the root will be mobile. The more accurate method is X-ray. In case of dislocation, the image will show an even increase in the periodontal gap on both sides, and the bottom of the hole will be empty.

X-ray diagnostics

Treatment

The original damaged tooth is put back in place. The dentist sets the tooth under local anesthesia. Then, by grinding the edges, it is removed from the bite, then splints are applied for several months.

  1. The viability of the pulp is checked by electrodiagnostics. After that, the question of its preservation or deletion is decided. This procedure is carried out within two months. During this period, pulp recovery is possible. In case of loss of viability, the pulp is removed, the canal is filled.
  2. Ligature binding of incisors. The procedure is carried out using a thin bronze-aluminum or steel wire, 0.4 mm thick. However, this method does not allow for as rigid fixation as required.
  3. Brace bar made of stainless wire or steel tape. Placed on the damaged tooth and adjacent multiple teeth on either side. It is indicated for use in permanent occlusion, in the presence of a sufficient number of crowns next to the bruise.
  4. Gingival splints are used for any bite, even with a lack of adjacent incisors. It is made of plastic with reinforced wire, after taking the patient's jaw impression.
  5. The use of composite materials, with the help of which fixation is performed. All these manipulations should be carried out within a month. During this period, oral hygiene must be performed with great care.

Spreading of teeth after replantation

Impacted dislocation in children

Children often fall and face bumps. Therefore, impacted teeth are far from uncommon.

Such an injury requires individual treatment. You won't be able to deal with the problem quickly, so you need to be patient.

Initially, you need to assess the degree of damage to the bone tissue and the hole. Most often, a wait-and-see tactic is chosen. This is necessary in order to see how the causative tooth will behave. The milk tooth will erupt itself again. A special diet is prescribed and monthly check-ups are carried out.

If such an unpleasant situation has occurred, it is necessary to check the rudiment of the molar for damage. In the case when the extension did not occur, the milk one is already removed. On x-ray, the crown itself will be displayed in the hole, and its root above the hole. May cause deformation of the alveolar walls and destruction of the bottom.

Danger of dental injuries in children

The main danger is not the loss of a baby tooth, but the fact that the molar can erupt not completely healthy.

People have the rudiments of molars already in infancy. They just start growing at about five or six years old. They are located in the jaw body, and at a certain time they begin to grow, displacing the milk ones. Before this process, preparation takes place in the body of the little man. The roots of milk teeth gradually dissolve, making room for the next change.

The onset of molars by the age of five to six is ​​in close contact with the milk teeth. Therefore, if you hammer in a fickle tooth, then the rudiment of a permanent one is likely to be damaged. With a complete dislocation, the beginning is not injured, but there is a high probability of enamel chipping.

If the rudiments of permanent teeth are injured, there is a high risk of inflammation, which can lead to ostiomyelitis of the jaw apparatus. Rarely, with dislocations of milk, the roots appear with insignificant deviations, but this is all easily treatable. The main thing is to pay attention on time and come to a specialist.

The child has a dislocated tooth, what to do

Dental trauma can directly cause jaw deformation. Therefore, the examination should be carried out not only by a dentist, but also by a traumatologist. A very active lifestyle of a child leads to such serious injuries as damage to the root and crown, bruises.

According to the specifics of the injury, there are:

  • sports;
  • household;
  • road.

The most serious injuries occur during sports activities, as a result of falls or fights. There is another type of injury - chronic. This happens if the child often chews on nails, pencils and other objects. Such seemingly harmless reasons lead to thinning of hard tissue and enamel chips.

Sports injury is the most difficult

What should you pay attention to?

Complaints of the child about recurrent pain sensations, aggravated by minimal exertion. Such complaints can signal injury. There may be bruising or swelling in its place. The crown may turn pinkish.

A dislocated tooth or a tooth fracture causes pain in the first hours after the injury.

Complications that can lead to dislocations:

  • necrosis;
  • obliteration of the pulp;
  • loss of bone fixation;
  • resorption of the root system.

Dislocations are most common among childhood injuries, not tooth and root fractures. This is due to the fact that the bones are quite elastic in children, and the roots are still quite short in comparison with the molars.

Fracture of a tooth in the visible part

In ten percent of cases, after injuries of milk teeth, permanent ones erupt with hypoplasic spots (damage to the enamel).

They can be white or yellow-brown in color. It is also possible a violation in the development of crowns or roots of molars. Such damage is more serious, but extremely rare.

Minor injuries are treated without intervention, with X-ray diagnostics and clinical monitoring on a monthly basis.

X-ray displacement of the tooth root

Strong displacements require radiological confirmation of the location of the root and its integrity.

Vestibular root displacement suggests self-healing.

A permanent tooth can also regenerate autonomously. When removing an impacted milk tooth, there is a high probability of damaging the molar. Recovery will take from one month to six months. If the tooth does not move to its original place within two months, this indicates the development of ankylosis. This course of events requires immediate removal.

If there is a displacement of the root of the milk tooth towards the permanent one, then the damaged incisor is removed.

The opinions of specialists on the treatment of dislocation of primary teeth differ. Some people advise deleting them immediately. Others believe that inconsistent teeth with dislocation should be preserved. You need to seek the help of professionals, and, against the background of their recommendations, make your own decisions. Do not let the problem take its course, because in this case you may face a lot of unpleasant moments.

Most often, trauma to milk teeth occurs by accident or as a result of an accident. Children learn to walk, run, climb to a height, jump from a swing, swing something hard and heavy - all these are situations in which the risk of dislocation, contusion or tooth fracture increases.

According to statistics, 30% of children go to the doctor with complaints of tooth trauma, the maximum number of cases falls on the age of 2-4 years and 8-10 years. Boys are more susceptible to this. Blunt trauma (impact) damages soft tissues. A local hematoma (bruise) occurs.

Treatment of dental injuries in children often causes difficulties for the dentist, because at the time of treatment, the child is usually especially anxious and excitable. The sight of blood, pain, etc.

Bruises and subluxations of the teeth

With a bruised tooth, the child is worried about the pain that occurs when food gets on it.

Contusion is damage to the tooth, in which its displacement and mobility are not observed. In case of subluxation, the tooth can be mobile, but remains in place. In both cases, the periodontal ligament surrounding the tooth crown is also damaged. Because of this, a child after an injury may complain of pain when food gets on his teeth. In the area of ​​injury, there is always hemorrhage (bruising) and swelling, but the appearance of blood from the gums is possible only with subluxation.

Dislocation of milk teeth

Tooth dislocation is a condition in which it has been displaced in the bone. A type of such injury is a hammered dislocation. The mechanism of its development is the same as when hammering in a nail. The front milk teeth most often take a blow at the moment the baby falls and move up and towards the sky (inward). If, with such damage, the crown of the tooth is visible, then often no intervention is required. The tooth will erupt again over time. But in cases where the milk tooth is deeply embedded in the bone and there is a risk of damage to the rudiments of permanent teeth and the bone itself, the doctor will recommend the removal of such an injured tooth.

Tooth dislocation can be to the side (lateral) or complete, when the tooth simply falls out of the socket. In such situations, you should not try to put it back, risking an infection in the bone and causing inflammation of the jaw. After a spontaneous stop of bleeding from the hole, a blood clot forms in it, which contributes to its early healing. Rinsing it thoroughly is a common mistake of parents.

Fractures of milk teeth


The chipped part of the milk tooth is corrected with a filling material or sharp edges are sanded so that they do not injure the surrounding tissues.

Fractures of permanent teeth are more common. When a part of the crown of a deciduous tooth breaks off, the missing part of the tooth can be restored with filling materials or sharp edges can be smoothed out with an abrasive instrument. The doctor may advise covering the tooth with a metal crown cap after removing the nerve. This treatment option is especially recommended if the pulp (a nerve with a vessel inside the tooth) is damaged at the time of injury. Not only a breakaway of the visible part of the tooth, but also an internal fracture of the root can occur. In such cases, the outer part of the tooth will be mobile, and the doctor can only see the fracture line on an X-ray. For any type of injury received, such an examination is necessary. The dentist usually recommends doing it again after 3 and 6 months in order to track the onset of possible complications.

The doctor should discuss any consequences of the dislocation and fracture of milk teeth with the parents of the child. Sometimes it is difficult for a doctor to give an accurate prognosis. Parents, as a rule, are concerned about the risks of damage to the rudiments of permanent teeth after an injury. This is most likely with a hammer-in dislocation and fracture in very young children.

According to statistics, every third child gets a baby tooth injury. Do not panic too much if you are faced with such a situation. Consult a pediatric dentist for advice. This will avoid unnecessary complications and possible dental problems in the future.

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Maxillofacial injuries are common in both children and adults. The reasons for their occurrence are different, and depend on the age of the patient.

Tooth dislocation takes one of the first places among all such injuries. It is characterized by a change in the position of the tooth relative to all other bone structures of the jaw. Damage to surrounding tissues and blood vessels is noted.

Causes of injury

The etiology of this pathology is most often the trauma of the facial section of the skull. As a rule, the anterior upper teeth (incisors and canines) are injured.

Dislocation reasons:

  • Injury to the maxillofacial apparatus when a direct blow is applied, usually in a fight, when falling from a height of one's own height and above, and so on. The front teeth are damaged. This problem often occurs in professional athletes (for example, boxers), children and adolescents;
  • Various accidents, in which, as a rule, a person receives multiple injuries to the body and head;
  • Ingestion of hard, hard parts in soft food;
  • Violation of the technique of tooth extraction. In this case, the structures supporting the adjacent healthy teeth can be damaged (trauma to the ligamentous apparatus). This can happen when molars are removed;
  • A frivolous attitude towards their teeth, which is expressed in their use for other than their intended purpose (chewing food). Many people, especially men, use them to open bottles with metal caps, split the peel with them;
  • Eating overly hard foods that require extra effort when biting off.

Symptoms and types of dislocation

The clinic of pathology will directly depend on its type. It should also be borne in mind that the symptoms in children and adults are somewhat different.

Symptoms of a dislocated tooth, depending on its type:

  • Incomplete tooth dislocation- trauma, characterized by the preservation of the tooth in its hole and accompanied by partial damage to the periodontium (the substance surrounding the tooth itself and contributing to keeping it in place). The clinical picture in this case is as follows:
    • Intense pain during the injury, which remains after it. It can be permanent, or it can occur when chewing and at the time of the bite;
    • Due to the presence of pain, the jaw is in a forced position, that is, the mouth does not close completely. Thus, the patient tries to avoid the occurrence of sharp repeated pain;
    • The location of the tooth (bone formation) is different from the usual one. Its body can be deflected in any direction, but it does not move beyond the row of healthy teeth;
    • There may be a slight mobility of bone formation;
    • Signs of gum inflammation. It becomes red (hyperemia) and swollen, its soreness is noted on palpation (feeling);
    • Damage to the surrounding soft tissues (lips, cheeks) is often observed. On examination, hematoma and tissue swelling are visualized. On palpation, there is an increase or the occurrence of pain.
  • Complete dislocation of the tooth characterized by complete loss of the tooth from the hole, while damage to the ligamentous apparatus occurs, and its root can be injured. This type of pathology is accompanied by a certain symptom complex:
    • Pain at the site of the lost bone formation;
    • Bleeding from the hole, the formation of a blood clot may be observed;
    • Inflammatory phenomena on the gums: hyperemia, pain, swelling, hematomas, local fever (the gum is hot to the touch);
    • During a conversation, a person begins to lisp or whistle. This phenomenon is temporary.
  • Impacted dislocation- This is an injury in which the body of the tooth is immersed in the jaw tissue (it enters into the depth of the hole) under the influence of a large pressing force. In this case, serious damage to the tissues of the maxillofacial apparatus occurs (destruction of the alveoli, periodontium, corpus spongiosum, and so on). Signs of this pathology:
    • Severe pain that is persistent;
    • The patient is unable to close the jaw;
    • Isolation of blood from the well;
    • The tooth is motionless, with palpation there is an increase in pain;
    • The gums around the affected area are swollen, painful, and reddened;
    • The tooth becomes smaller in height or is completely hidden in the hole, while its chewing part is revealed during a dental examination.

Trauma diagnosis

Diagnosis of this type of injury is straightforward. It consists in the collection of anamnesis, examination and X-ray examination.

When a patient applies for dental care, it is necessary to conduct a survey. You should find out the reason, that is, the circumstances under which the injury was received. The patient is then questioned in detail about the complaints.

The next stage of diagnosis is a dental examination. The victim is seated in a dental chair and an examination of the oral cavity is carried out in good lighting. The doctor identifies the symptoms described above. Percussion (tapping) and palpation of the tooth and surrounding tissues are mandatory.

X-ray examination is indicated to detect damage to the internal structures of the jaw. In case of incomplete dislocation on the X-ray image, the shortening of the tooth root is determined, in some cases its fracture is revealed. This diagnostic method is of great importance in case of impacted dislocation. It is necessary to detect internal damage, and also helps to detect the position of the tooth when it is fully immersed.

First aid

If a person is injured in the maxillofacial apparatus, then it is necessary to seek medical help as soon as possible. Depending on the severity of the patient's condition, the question of his hospitalization by an ambulance is decided, or he turns to specialists on his own. In the event of severe and numerous injuries, it is advisable to call an ambulance.

Before contacting a doctor, it is necessary to provide the victim with first aid, which consists in the following:

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Tooth dislocation treatment

The choice of treatment for this injury depends on its type, as well as the degree of damage to the tooth and surrounding tissues. Can a tooth be saved? This question can only be answered by a dentist after an examination.

If the tooth can be saved, then first it is given a physiological position (that is, the tooth is installed in its original place). This procedure is performed using local anesthesia. After that, the tooth must be fixed.

After fixation, the doctor should check the condition of the pulp using a current. This diagnostics is carried out over time. If the reaction is excessively strong (more than 100 μA), then this is a sign of tissue necrosis. In this case, it is necessary to remove the pulp.

Treatment of impacted dislocation

This injury takes a long time to heal, the doctor individually approaches the problem. To begin with, the severity of the lesion is determined, after which a therapeutic tactic is selected:

  1. A waiting position, in this case the patient is under the supervision of a specialist and periodically comes for an examination. Spontaneous protrusion of the tooth is expected. This method is chosen if it is submerged shallowly, and the tissues remain intact;
  2. Extraction of a tooth with its subsequent restoration.

Treatment of incomplete tooth dislocation

The sequence of treatment in this case:


If a repeated examination reveals pulp necrosis, the tooth is opened, the pulp is removed and the canals are sealed.

There are several ways that will help fix the affected tooth:

  • Ligature binding is a method of immobilization using a thin stainless wire (0.4 mm in diameter). It consists in tying the damaged and adjacent teeth together with the help of a wire figure eight. For this to be possible, it is necessary to have 2 or 3 healthy teeth on each side of the damaged one. Committing with this method is unreliable;
  • Kappa splint, it is made of plastic. Often used in pediatric dentistry. However, this splint can lead to a change in bite, which is especially undesirable for children;
  • Brace tire, it can be either tape or wire. This method is used in the presence of permanent teeth. The bus is made of stainless steel wire or strip. The material is bent according to the shape of the dentition. The splint is fixed with a thin wire, it is installed on the damaged and adjacent healthy teeth on both sides;
  • Composite material that helps to fix the splint to the dentition;
  • Supragingival splints. This method is widely used for both temporary and permanent occlusion, as well as in the event that there is not a sufficient number of adjacent teeth. To make a tire, it is necessary to take an impression, according to which, in the future, a construction of wire and plastic will be created.

When the tooth is in place, the chewing surface is usually filed down a little. This procedure is carried out in order to exclude the affected bone element from the act of chewing. That is, in this way, the load is significantly reduced, and at the same time, the likelihood of repeated dislocation.

Fixation is carried out for 1 month... The doctor should periodically check the condition of the pulp and, if necessary, remove it, sanitize the canals and fill them.

Complete dislocation treatment

In this case, the treatment is to restore the tooth. Much depends on the patient, in some cases he simply throws out the lost tooth. This is especially often observed in the event that a complete dislocation of the baby's tooth has occurred in a child.

Treatment stages:

  1. Removal of pulp, sanitation and subsequent filling of canals;
  2. Recovery procedure - replantation;
  3. Fixation for 1 month;
  4. A special diet that consists of avoiding traumatic foods.

Replantation is carried out in the following sequence:

  1. The preparatory stage, which includes the processing of the tooth and the preparation of the hole;
  2. Returning the tooth to its place;
  3. Fixation;
  4. Monitoring the dynamics in the postoperative period.

Tooth restoration can be carried out simultaneously (at one time) or delayed.

Recovery after dislocation

Recovering from an injury is a long and laborious process. Its success will depend on a number of factors:

  • The type of damaged tooth (milk or permanent);
  • Severity of injury;
  • The age of the patient;
  • How soon after the injury was treated;
  • Has the dental treatment been performed correctly?
  • Physiological characteristics of the body.

After the treatment, the tooth can either take root or be torn away. Moreover, rejection can occur both immediately and after several months or even years. Rejection usually occurs when a person's immune system begins to react to dental tissue as foreign agents. Antibodies to it begin to be produced. This phenomenon is infrequent, but any person can face it.

After restoration of the tooth, partial or complete root resorption may occur.(resorption). If replantation was performed as soon as possible (no more than 30 minutes), after injury, then minimal resorption occurs and the tooth remains for a long time. In the event that a person sought medical help late, then soon after recovery, root resorption is observed. This process can continue until it is completely destroyed. This, in turn, will lead to tooth loss.

Dislocated tooth in a child

More than 30% of children receive various injuries of the maxillofacial apparatus. Most often, parents apply for dislocation of milk teeth, since they are not fixed in the hole as reliably as permanent ones.

If an incomplete dislocation of a milk tooth occurs, then after examination the doctor decides whether it is necessary to reposition it. In some cases, the tooth is not touched if there is no damage to the surrounding tissues and the permanent tooth, which is located under the milk one.

The symptoms of dislocation in children are similar to those in adults.... However, some features are highlighted:


Impacted tooth dislocation is especially dangerous if the child has milk teeth... When a child's temporary teeth grow, then permanent teeth are located under them. They begin to gradually push out the milk, which leads to their loss. If a temporary tooth is pushed into the gum with force, it can damage the permanent one. Moreover, the steppe of damage is different.

Impacted dislocation of a milk tooth is dangerous, as it can damage future molars.

If the rudiments of permanent teeth are injured, then their inflammation and the development of osteomyelitis may occur. If treatment is not started on time, the child may lose not only temporary, but also permanent teeth. That is why, if such an injury is found in a child, it is necessary to consult a dentist as soon as possible.

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