One of the most unpleasant diagnoses in our practice is a fractured tooth. Depending on the severity of the fracture, it is assessed how it can be restored. The worst prognosis for traumatic dental injuries is the impossibility of preserving the tooth. In that case, a radical treatment method called extraction is applied.
What is the cause of the fracture?
- Deep decay
- Trauma
- Improperly restored tooth
- Parafunctional habits – teeth grinding (bruxism), etc.
One of the most common causes of tooth fractures is trauma. Fractures often occur during eating, when biting down on a hard particle of the food (occlusal trauma). Trauma and tooth fractures can also occur in accidents such as falls, car crashes, and impacts.
Types of fractures:
Based on the group of teeth:
-
Fractures of the anterior (frontal) teeth
Fractures of the posterior (back) teeth
Based on the affected part of the structure:
- Crown fractures
- Root fractures
- Both crown and root fractures
Based on the type of fracture line:
- Oblique fractures
- Vertical fractures
- Horizontal fractures
What should I do if a tooth is fractured?
Our team at Noradent advises timely visits to a dental professional. It is important to preserve the broken piece, if available. This is recommended because there is a possibility to adapt the missing part in the mouth using special composite materials and adhesive techniques.
Symptoms that may accompany a fractured tooth include pain while chewing, pain when applying pressure, spontaneous pain, pain triggered by chemical or thermal stimulation, swelling and redness of the gum around the tooth, mobility, bleeding, etc.
Treatment methods and restoration of a fractured tooth
The treatment methods for traumatised teeth depend on the type, location, and symptoms of the fracture. When the fracture occurs in the enamel and dentin tissues, the tooth can be restored with a composite material. The first step in the treatment process involves isolating the area with a rubber dam, which keeps the operative field clean and dry. Then, our specialists at Noradent begin layer-by-layer application of the composite material.
The restoration takes into account all the anatomical characteristics of the teeth structures – shape, texture, colour, etc. Finishing and polishing of the filling are done afterwards.
For larger destruction, where multiple dental structures (broken cusps and walls of the tooth) are missing, indirect restoration methods such as onlays or overlays are used.
These are laboratory-made fillings that are sealed using an adhesive technique. Two visits are required – one for taking an impression and another for placing the restoration.
In the case of complicated crown fractures, biological treatment or routine endodontic treatment is necessary. The decision between these two treatment options depends on various factors such as the size of the ulcer, the degree of bleeding, the patient’s age, etc.
Biological treatment involves the use of a special bio-compatible material that forms a barrier between the dentin and the pulp. If root canal treatment is indicated, the root canals of the tooth are mechanically and chemically cleaned.
In cases where the pulp tissue is non-vital and there are missing tooth walls due to a complicated fracture, a full-coverage crown (ceramic or zirconia) is fabricated.
In the case of a horizontal root fracture, the treatment consists of immobilisation (splinting) and monitoring.
A vertical root fracture of the tooth requires timely extraction. The final manipulation is preferably performed by an oral surgeon. The restoration of a non-restorable fractured or missing tooth can be done with the placement of an implant or a bridge. The dental team analyses and determines the most suitable option based on the clinical case.
At Noradent, we believe in the expertise of dental professionals and a multidisciplinary approach to treatment.
Dental Studio Noradent - City Center, Sofia, Bulgaria
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