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Fracture of tooth root
03-09-2009
Fracture of the root of the tooth may occur near the neck of the tooth, in its central part, on the border of the middle and apical thirds, near the top. The direction of fracture lines often cross, rarely slightly oblique. It passed through the cement, the dentin, the tooth pulp. If the fracture line of two or more, to speak of comminuted fractures of the root. According NM Chupryninoy et al. (1993), the roots of incisors often break between the middle and apical third (69.0%), equally often – in the neck and middle (14.5%), rarely – near the top of the root (2%). At the turn of the root of the tooth, patients may complain of spontaneous pain in his aching tooth with varying intensity, increasing with biting food, tooth mobility, discomfort and pain during interdigitation. Fracture of the root is always accompanied by dislocation of his crown part. Then there are clinical signs characteristic of the dislocation of the tooth.
Determine the root fracture and to distinguish it from the dislocation of the tooth allows simple clinical method. If your right hand to make minor amplitude swaying movements of the tooth crown in the anteroposterior direction, the II finger of his left arm, located on the vestibular surface of the alveolar process, you can feel the synchronous movement otlomlennogo root. Can quite accurately determine the level of fracture of the root. This technique proves to be unreliable only when the turn of the root apex of the tooth. In such cases, contact with the tooth and percussion painful, he has mobility, but due to the increased thickness of the walls of the hole in the apex of the root boundary between moving and fixed part of the root can not be determined. Mistake can be diagnosed with a fracture dislocation of the tooth in place. However, such fractures are rare (2%). Color crown of the tooth is usually not changed, but the fracture located near the crown of the tooth, it is due to rupture and hemorrhage in the pulp cavity can be painted in pink, and later, as the transformation of hemoglobin into hemosiderin, to acquire a yellowish tint.
X-ray study allows to clarify the localization of the fracture line, its direction, the nature of the displacement of bone fragments, the state of periodontal and bone tissue alveoli. On radiographs the fracture line appears in the form of a narrow or wide (depending on the magnitude of the displacement of bone fragments) strips of enlightenment at the root of the tooth, sometimes with a step, demonstrating the shift of fragments in the side. If the fractured tooth root fracture accompanied by a wall of the alveoli, then the x-ray can determine the course of breaking a compact disc alveolar bone within the hole of the tooth and the strip of enlightenment in the spongy substance of bone tissue.
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