Management of Subgingival Incisor Fractures with a Diode Laser
Journal Title: Interventions in Pediatric Dentistry Open Access Journal - Year 2018, Vol 2, Issue 1
Abstract
Management of subgingival fractures of incisors is difficult. This case study introduces the concept of using a diode laser as another tool in the treatment of fractured maxillary incisor teeth. Two cases illustrate the success of using a diode laser to manage the two problems of marginal access and hemorrhage in subgingival fractures. Dental trauma creates some of the most demanding situations the clinician will face in the office. The patient is injured, scared, and wondering if they can be whole again. The parent is frightened, fighting guilt, and wondering what the outcome will be. Subgingival tooth fractures of maxillary incisors start a cascade of questions in the clinician’s mind. Are the pulpal tissues exposed? How far do the fractures extend? How do I restore this tooth, and will I need help from other dental specialists? The introduction of the diode laser has answered many of these questions. Many cases involving subgingival fractures of incisor teeth can be successfully treated with excellent results with the addition of the diode laser to traditional management techniques. There are three basic treatments for sub-gingival crown fractures reported in the literature. The first is orthodontic extrusion [1]. One considers orthodontic extrusion when the fracture is below the gingival margin and the lack of access compromises the integrity of the gingival margin of the restoration. Orthodontic extrusion is also indicated when the biologic width will be compromised with a restoration. The clinician must decide how to move the tooth in relation to the alveolar bone and crest. Simple extrusion will suffice if the intent is to extrude the tooth to gain access to the fracture margin. After the tooth has been extruded, a gingivectomy procedure will give the clinician access to the entire margin. If the intent is to extrude the tooth out of the alveolar bone to gain access to a crown fracture or near crown-root fracture the plan must include rapid extrusion. Rapid extrusion is used to move the tooth out of the alveolar bone to gain access to the fracture.
Authors and Affiliations
John R Christensen, Linwood M Long
Keywords
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- EP ID EP577599
- DOI 10.32474/IPDOAJ.2018.02.000127
- Views 76
- Downloads 0
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