DENTAL LECTURE SUR LE TRAUMA DENTAIRE

2. ‫الرحي‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬‫م‬

3. DENTAL TRAUMA

4. ‫الجذور‬ ‫عالج‬
‫و‬
‫رضوض‬‫األسنان‬

5. ‫أول‬ ‫صنف‬:‫يشمل‬ ‫بسيط‬ ‫كسر‬
‫فقط‬ ‫الميناء‬.
‫ثاني‬ ‫صنف‬:‫يشمل‬ ‫تاجي‬ ‫كسر‬
‫الل‬ ‫انكشاف‬ ‫دون‬ ‫والعاج‬ ‫الميناء‬‫ب‬.
‫ثالث‬ ‫صنف‬:‫المين‬ ‫يشمل‬ ‫كسر‬‫اء‬
‫لبي‬ ‫انكشاف‬ ‫مع‬ ‫والعاج‬-

6. ‫رابع‬ ‫صنف‬:‫فقدان‬ ‫بدون‬ ‫أو‬ ‫مع‬ ‫اللب‬ ‫تموت‬
‫التاج‬.
‫خامس‬ ‫صنف‬:‫خارج‬ ‫السن‬ ‫كامل‬ ‫انخالع‬
‫السنخ‬.
‫سادس‬ ‫صنف‬:‫فقدان‬ ‫بدون‬ ‫أو‬ ‫مع‬ ‫الجذر‬ ‫كسر‬
‫التاج‬.
‫سابع‬ ‫صنف‬:‫كس‬ ‫أي‬ ‫بدون‬ ‫السن‬ ‫مكان‬ ‫تبدل‬‫ر‬
‫فيه‬.
‫ثامن‬ ‫صنف‬:‫بأكمله‬ ‫التاج‬ ‫كسر‬.
‫تاسع‬ ‫صنف‬:‫رضوض‬‫المؤقتة‬ ‫األسنان‬.

7. Enamel fracture

8. Enamel fracture
A fracture confined to the enamel with
loss of tooth structure.

9. Treatment
If a tooth fragment is available, it can
be bonded to the tooth.
Grinding or restoration with composite
resin depending on the extent and
location of the fracture.
Three angulations (periapical, occlusal
and eccentric exposures) should be
used in the radiographic examination
to rule out luxation injuries or root
fractures.

11. Follow-up
Clinical and radiographic
control at 6-8 weeks and
1 year

12. Enamel-dentin fracture

13. Enamel-dentin fracture
A fracture confined to enamel and
dentin with loss of tooth structure, but
not involving the pulp.

14. diagnostic signs
Description A fracture
confined to enamel and
dentin with loss of tooth
structure, but not
involving the pulp

15. diagnostic signs
Visual signs Visible
loss of enamel and
dentin. No visible
sign of exposed
pulp tissue.

16. diagnostic signs
Percussion test Not
tender. If tenderness
is observed evaluate
the tooth for possible
luxation or root
fracture injury.

17. diagnostic signs
Mobility test
Normal mobility.

18. diagnostic signs
Sensibility pulp test Usually
positive. The test may be
negative initially indicating
transient pulpal damage.
Monitor pulpal response
until a definitive pulpal
diagnosis can be made.

19. diagnostic signs
Radiographic
findings The
enamel-dentin
loss is visible.

20. Treatment
If a tooth fragment is available, it
can be bonded to the tooth.
Otherwise perform a provisional
treatment by covering the exposed
dentin with glass-ionomer or a
permanent restoration using a
bonding agent and composite
resin.

21. Follow-up
Clinical and
radiographic control at
6-8 weeks and 1 year

26. DENTINAL TUBULES

27. Odontoblasts and process

28. Fracture of both enamel and dentin

29. Enamel-dentin-pulp fracture
(Complicated crown fracture)

30. A fracture involving enamel and dentin
with loss of tooth structure and
exposure of the pulp.

31. diagnostic signs

32. Description A fracture
involving enamel and
dentin with loss of
tooth structure and
exposure of the pulp.

33. Visual signs Visible
loss of enamel and
dentin and
exposed pulp
tissue

34. Percussion test Not
tender. If tenderness
is observed evaluate
the tooth for luxation
or root fracture
injury

35. Mobility test
Normal mobility

36. Sensibility test
Usually positive

37. Radiographic findings The loss
of tooth substance is visible

38. Enamel-dentin-pulp fracture
Treatment
In young patients with open
apices, it is very important to
preserve pulp vitality by pulp
capping or partial pulpotomy in
order to secure further root
development.. Calcium hydroxide
compounds and MTA (white) are
suitable materials for such
procedures

39. In older patients with
closed apices and an
associated luxation injury
with displacement, root
canal treatment is usually
the treatment of choice

40. What is a Pulpotomy?

41. In baby molars, a pulpotomy is used in
the process of trying to save and
restore the tooth. First, the decay is
removed, and then the pulp chamber
(the top part, not the root canals) is
removed usually with a high-speed bur
or spoon excavator. A small cotton ball
damp with formocresol is placed to
"mummify" the pulp stumps and to
sterilize the area

42. pulpotomy

43. After a couple of minutes, the
cotton ball is removed and the
opening is sealed usually with a
Zinc Oxide and Eugenol
material like IRM. IRM is a putty
like material that hardens up
after a few minutes.

44. After a pulpotomy on a baby molar, it
is usually necessary to place a stainless
steel crown to restore the tooth

45. Objectives for the CaOH
Pulpotomy of Young
Permanent Teeth
(Apexogenesis)

46. • preserve radicular vitality,
• maximize the opportunity
for apexogenesis (apical
development and closure),

47. Clinical Technique for the CaOH
Pulpotomy of Young Permanent Teeth

48. • 1. Anesthetize the tooth and
isolate under a rubber dam.
• 2. Excavate all caries and
establish a cavity outline.
• 3. Irrigate the cavity and lightly
dry with cotton pellets.
• 4. Remove the roof of the pulp
chamber

49. • 5. Amputate the coronal pulp with a
large low-speed round bur .
• 6. Control hemorrhage with a cotton
pellet applied with pressure or a damp
pellet of hydrogen peroxide.
• 7. Place a calcium hydroxide mixture
over the radicular pulp stumps at the
canal orifices and dry with a cotton
pellet.

50. • 8. Place quick-setting ZOE
cement or resin-reinforced glass
ionomer cement over the calcium
hydroxide to seal and fill the
chamber.

54. Dental Abscess

56. Traitement d'urgence : drainage de
l'abcès par technique classique
(par la poche si possible, ou par
une incision au centre de la
voussure) .Antibiothérapie
(traitement par antibiotiques)
souvent

60. ‫عليكم‬ ‫السالم‬