Broken front tooth
synonym
Anterior tooth trauma
introduction
Especially in toddlers, schoolchildren and adolescents, a fall can cause an incisor to be affected. The so-called "front tooth trauma" (broken incisor) is one of the most common injuries in the oral cavity. In general, it can be assumed that in every second person within the first 50 years of life an incisor has broken off at least once. While anterior tooth trauma in the lower jaw is comparatively rare, impairment of the anterior teeth of the upper jaw can often be observed in everyday clinical practice. If an incisor has broken off, it is essential to clarify whether the affected tooth can be preserved. In this context, it should be determined whether only a portion of the tooth substance lying above the gum margin has broken off or whether the bone compartment and / or the surrounding gums have also been affected.
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Since it is mainly in the course of traumatic events, for example a Fall, Blow or Push, if an anterior tooth trauma occurs, additional possible Accompanying injuries be excluded. For this reason, depending on the course of the accident, a X-ray examination of the jaw and of the midface respectively.
In the case of people who have broken an incisor, the most important thing is to Broken bones in the area of the upper and lower jaw, the zygomatic bone and the eye socket be excluded. In addition, a broken incisor is often associated with other complaints. Whether and what kind of complaints occur in connection with the broken incisor depends primarily on the extent of the tooth damage. Especially when an anterior tooth is almost completely “torn off”, it usually comes about severe pain and Bleeding. In the case of a slightly pronounced anterior tooth trauma, on the other hand, the patient concerned only has one visual impairment perceived. Pain are more like a in these cases rarity. Nevertheless, an anterior tooth that has broken off urgently to a dentist should lead. Especially with a pronounced one Front tooth trauma in children or adolescents, the tooth can be preserved if necessary with immediate restoration.
Figure broken off tooth
Broken tooth
Tooth fragment
- Tooth fragment,
broken tooth
or tooth piece
Do not clean! - Storage -
Glass of milk,
sterile saline solution,
moist storage! - One is ideal
Tooth rescue box
(Pharmacy) - As soon as possible
Go to the dentist
(up to 24 hours) - Attached tooth fragment
(special adhesive technology,
Plastic glue)
You can find an overview of all Dr-Gumpert images at: medical illustrations
Symptoms
If an incisor has broken off, this does not necessarily lead to accompanying complaints. Whether and to what extent accompanying symptoms occur depends primarily on the extent of the anterior tooth trauma. Basically, a broken incisor can be associated with various symptoms. They also play the cause of the emergence of the Incisor damage and possible accompanying injuries in this context a crucial role.
In general, it can be assumed that an incisor that has broken off particularly close to the gumline will cause more pronounced symptoms. In addition, an incisor trauma that results in complete tooth loss is usually accompanied by severe discomfort. Patients who have an incisor that completely canceled is usually suffer from particularly severe pain. In addition, it often occurs in the wake of trauma Bleeding in the area of the tooth socket.
At a deep anterior tooth trauma with opening of the dental pulp, can also strong pain observe. In such a case, the broken incisor cannot simply be reattached. By opening the dental pulp will be tiny nerve fibers affected. For this reason, the discomfort would not subside even after the broken incisor was reattached. Rather, in such a case it can be assumed that the incisor that has broken off is ignited. In the case of a deep anterior tooth trauma with opening of the dental pulp, a Root canal treatment carried out. In this way, the tooth stump remaining in the jaw can be used as an anchor and with a Crown are supplied. In addition to the incisor that has broken off, an impairment of bony structures may also be detected. Because of this, belong local swelling and or Bruising (Hematomas) one of the most common symptoms accompanying a broken incisor.
causes
A broken incisor can almost always be caused by one traumatic event can be assumed. Especially mechanical injuries in the form of horizontal forces play a crucial role in this context. In addition, the typical causes for an incisor that has broken off can be assigned to the age of the patient concerned.
Especially with Small and school children be valid Falls and Bumps one of the most common causes for the development of an anterior tooth trauma. Corresponding accidents usually take place in the context of physical education or while romping around. For this reason, possible accompanying injuries must always be excluded in the case of an incisor that has broken off. In the course of diagnostics, especially in the case of pronounced anterior tooth trauma X-rays of the jaw and midface be made. Strong forces on the incisors can, for example, with a Upper or lower jaw fracture accompanied.
At Adolescents and adults People get through it often Accidents or physical disputes to the appearance of an incisor that has broken off. In these cases, too, it is imperative that you promptly Dentist to be visited. In particular, an anterior tooth trauma that arises in the course of a physical dispute can possibly result in bone fractures in the area of the Jaws, of Zygomatic bone and / or the Eye socket accompanied.
diagnosis
The diagnosis a broken incisor usually involves several steps. It usually starts with a detailed doctor-patient discussion (anamnese) carried out. During this conversation, the attending dentist tries to get a first clue about the severity of the anterior tooth trauma based on the symptoms and the description of the accident. In addition, the patient concerned should be aware of possible Underlying diseases (for example high blood pressure) and the taking medication be interviewed. Especially taking the drug aspirin can to heavy bleeding in the area of the compromised incisor.
Following the doctor-patient conversation, there is a Appraisal of the patient. In the case of an incisor that has broken off, this should result local swelling and Bruising outside the oral cavity be respected. In addition, both Upper and lower jaw, as well as Zygomatic bone and the Orbital Limits are scanned.
Noticeable edges or steps along these bony structures can be an initial indication of a Broken bone (fracture) deliver.
Then the Oral cavity, especially the affected half of the jaw to be examined. In this way, the extent of the anterior tooth trauma can be estimated. In this context must different ways of tilting the incisors can be distinguished. The so-called peripheral tilt includes all degrees of loosening (including complete tooth loss) of the incisor. Under the name "central tilt“On the other hand, one understands a tilting of the incisor in the direction of the Jawbone.
In addition, the actual Broken tooth in different types divided. In the case of a broken incisor, a distinction is made based on the size of the tooth fragment Jumps, Enamel-, Crown- and Root fractures.
Furthermore, in the case of an incisor that has broken off, the direction of the broken edge must be described. In this context one differentiates between Transverse, oblique and longitudinal fractures. Since an anterior tooth trauma cannot necessarily be clinically recognized as such, it is imperative that the jaw is subjected to an appropriate force radiographic examination be initiated. The extent of the anterior tooth trauma can usually be clearly seen on the X-ray.
therapy
When an incisor has broken off, the choice of the most suitable therapy depends on various factors. Especially that The extent and type of tooth fracture play a crucial role in this context. In addition, a distinction must be made as to whether the affected incisor is a Milk tooth or one permanent tooth acts.
At the Anterior trauma of a milk tooth the affected incisor is usually pulled. This way you can possibly be accompanying any pain is alleviated and a Impairment of the permanent tooth can be avoided. When treating a deciduous tooth that has broken off, however, it must also be noted that if the tooth is lost too early, there may be less space for the later erupting tooth tooth remains. For this reason, keeping the tooth gap open by a temporary prosthesis be useful.
With an incisor that only in the area of the crown is broken off, the defect can usually be with the help of a filling treated or with a artificial crown. In these cases, however, it must be absolutely ruled out that the Dental nerve was affected by the trauma.
If the broken incisor has a Opening of the dental pulp should therefore usually be a Root canal treatment be performed. In this way the emergence of inflammatory processes effectively prevented. After a short healing phase, the affected incisor can be used as an anchor for a crown.
If there is an incisor in the upper or middle Root area has broken off, it can generally not be assumed that the affected tooth can still be saved. In the case of an incisor that is in upper or middle root area has broken off, usually has to Tooth extraction respectively. Only in this way can the emergence of inflammatory processes and impairment of the bony Jaws be prevented.
With an incisor of the im lower root area is canceled, however, there is usually a much better prognosis. The affected incisor can often be preserved through the prompt removal of the root tip (so-called root tip resection) or root canal treatment. If an anterior tooth trauma results in complete tooth loss, an attempt can be made to reinsert the incisor into the jaw (so-called Reimplantation). In order to increase the chances of success of this treatment method, affected patients should urgently ensure that the incisor is properly positioned. The broken incisor should be because of this As moist as possible until you visit the dentist be stored.
Crown
In the case of an incisor that is in lower part of the tooth crown has broken off, the fracture fragment usually cannot simply be reattached. The reason for this is the fact that such a pronounced anterior tooth trauma often leads to Opening of the dental pulp comes. Be that way smallest nerve fibers affected. Would the canceled Crown simply reattached to the tooth stump, it can be assumed that inflammatory processes will develop in the area of the root canals within a very short time. For this reason, an incisor whose crown has broken off particularly deeply must have a so-called Root canal treatment be performed. In this way, the development of inflammatory processes can be effectively prevented.
In addition, this therapeutic procedure enables the tooth stump remaining in the jaw to be used as an anchor for an artificial crown. In many cases, this is still required during the root canal treatment Plastic pen placed in the tooth. This plastic pin also serves as a Stabilization of the artificial crown. In principle, an incisor that has broken off can different types of crowns be made.
The most common types of crowns in dentistry include:
- Full cast metal crowns
- Metal-ceramic crowns (short: VKM crown or veneer crown)
- All-ceramic crowns
For aesthetic reasons, the use of full cast metal crowns in the area of the incisors has meanwhile been refrained from. As a rule, a crown is made from metal-ceramic or all-ceramic to restore a broken incisor. The cost of fitting and inserting the crown will usually be partly from the insurance carriers accepted. In this context one speaks of the so-called basic supply. Any additional requests by the patient concerned, for example the Choice of an all-ceramic crown, lead to Special coststhat must be carried by the patient himself. In such cases, supplementary dental insurance often guarantees full coverage of the difference between the invoice amount and the health insurance share.
Gluing a tooth fragment
Is an incisor only on upper part of the tooth crown broken off, the treating dentist can often remove the fracture fragment glue. In order to assess whether gluing the tooth fragment can be effective, it must first be checked whether the tooth pulp has been opened. In the case of an incisor that has broken off particularly unfavorably, there may be a Damage to the smallest nerve fibers come. This often results in that inflammatory processes in the area of the tooth root form. Gluing the broken tooth fragment would in these cases in the long run no treatment success bring. Even if the incisor has broken off without opening the pulp, the tooth fragment can only be glued if it has been properly stored in advance. Affected patients must, if possible, have the broken tooth fragment up to the dentist's visit wet hold.
Provisional
In the case of an incisor that is in lower portion If the crown has broken off, a so-called Root canal treatment be performed. In this treatment method, the nerve fibers in the Inside the tooth root away. Then the tooth root can be treated with a special Filling material be locked.
Since with such a pronounced Anterior tooth trauma If large parts of the incisor have been affected, one must often artificial crown be made. However, no guarantee of success can be given with a root canal treatment.
In some cases, despite the removal of the root canals, they develop inflammatory processes. For this reason, it is recommended to make the artificial crown only after a waiting period. Since a tooth gap, especially in the area of the incisors, is considered unaesthetic, a so-called temporary restoration should be made until the crown is complete.
A provisional solution is a artificial tooth imitationto temporarily replace the broken incisor. As long as your own tooth root can be used as an anchor, the temporary restoration can be fitted with a special one adhesive to fix. In the event of an anterior tooth trauma with complete tooth loss, a removable temporary restoration can be made until the permanent denture has been completed.
costs
The costs, which arise in the treatment of a broken incisor, are mainly based on the Extent of anterior tooth trauma and the chosen treatment method. With an incisor the only aborted superficially is, will usually be a Filling therapy initiated. That with this treatment method used filling material (mostly a plastic), as well as the further costs are used by both private and statutory health insurances completely taken over. If the broken incisor has a Root canal treatment must be carried out, so are the costs involved mostly taken over by the insurance carriers.
Special extensions to the root canal treatment, for example the use of microscopes, however, require one Co-payment by the patient concerned. However, an anterior tooth trauma can also be so pronounced that the Dental crown even with the help of a root canal treatment cannot be saved. In these cases, the tooth stump remaining in the jawbone can only be used as an anchor for a crown. The costs associated with this treatment method will be partly from the insurance carriers accepted. A large proportion of the cost of that Adaptation, manufacture and insertion of such a crown must however from the affected patient be worn by yourself. Special dental insurance in such cases usually guarantee that the difference between the invoice amount and the cash portion will be fully covered.
Broken milk tooth in young children
A broken incisor can be seen quite often, especially in small children. Especially during the Raging or the first attempts at walking there are also more falls Anterior tooth trauma. According to the latest statistics, I suffer every third to fourth child up to their 16 age such a dental accident. In this context it must also be noted that a Milk tooth usually essential more unstable is as a permanent tooth. As a result, even comparatively slight acts of violence can lead to an incisor being affected.
If an incisor has broken off in a toddler, a dentist should definitely be visited. In many cases, the affected tooth can still be saved. In the case of a milk tooth, however, the therapy is often Removal of the tooth. In order to prevent consequential damage, for example an impairment of the permanent incisor that has not yet erupted, the tooth gap must often be kept open. For this purpose, for example, a removable dentures be made. If only a small part of the incisor has broken off in the toddler, this can be reattached with a special adhesive if necessary. In the case of an anterior tooth trauma to the milk tooth, consequential damage should not usually be expected.
