dsp 9 case 5 tooth fracture

8/15/2019 Dsp 9 Case 5 Tooth Fracture

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Universitas Padjadjaran

DSP9FKG 2012/2013

Dentoalveolar Fracture

Adlin Illani 160110123010

vel!n "o #en $%ie& 160110123011

'an (%i )in 160110123012

*+ Kar ,un 160110123013

Fa-i%a *adira% 16011012301.

Areeta Kaur )avier 16011012301

a& Sui #n+ 160110123016

Ais!a% Suian 16011012301


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$%ater 14 Introduction


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$%ater 2

iterature 5evie&

21 'oot% Fracture

211 Deinition

A tooth fracture is a break or crack in the hard shell of the tooth. The outer shell of the tooth is

called the enamel. It protects the softer inner pulp of the tooth that contains nerves and blood

vessels. Depending on the type of fracture, the tooth may not cause any problems or it may cause

pain.

Teeth can crack in several different ways:

$rac7ed toot%: This type of crack extends from the chewing surface of the tooth vertically

towards the root and sometimes below the gum line. A cracked tooth is not completely split into

two distinct movable segments. If caught early enough, the tooth is usually crowned but

endodontic therapy may be needed at a later date typically in the first ! months". #onsurgical

endodontic therapy root canal" will be needed when the pulp becomes substantially in$ured or

exposed. During endodontic therapy the inside crown portion of the tooth is stained with a

temporary dye and viewed microscopically for the extent of the fracture. %rognosis depends on

the severity of the crack. A full crown is needed to hold the tooth together.


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$ra8e lines: &ra'e lines are tiny cracks that affect only the outer enamel of the tooth. They are

common in all adult teeth and cause no pain. &ra'e lines need no treatment. They do #(T extend

into dentin. )ence, these cracks are observed in most teeth and are considered normal. They are

the result of *wear and tear* on teeth.)ence, the answer is no, not all cracks seen on the outside

of teeth are bad.

$usal racture: +hen a cusp or the pointed part of the chewing surface of your tooth becomes

weakened, the cusp will fracture. %art of the cusp may break off or may need to be removed by

your dentist. Depending upon the extent of the fracture, the pulp may also become damaged.


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ndodontic therapy is needed when the pulp is damaged beyond repair and a crown will be

placed to help protect the tooth and replace the fractured tooth structure.

Slit toot%: A split tooth is a cracked tooth in which the crack has progressed so there are -

distinct segments that can be separated from one another. nfortunately, with today/s

technology, a split tooth can never be saved intact. The extent and position of the crack will

determine if any portion can be maintained but most of these teeth will be extracted. In rare

instances, endodontic treatment, possibly some gum surgery, and a crown may be used to retain a

portion of the tooth.


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212 tiolo+!

Teeth are remarkably strong, but they can chip, crack fracture" or break. This can happen in

several ways:

i" 0iting down on something hard

ii" 0eing hit in the face or mouth

iii" 1alling

iv" )aving cavities that weaken the tooth

v" )aving large, old amalgam fillings that don2t support the remaining enamel of the tooth

213 $lassiication

llis classification Tooth fractures"

llis $lass I

namel fracture: This level of in$ury includes crown fractures that extend through the enamel

only. These teeth are usually nontender and without visible color change but have rough edges.

llis $lass II


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namel and dentin fracture without pulp exposure: In$uries in this category are fractures that

involve the enamel as well as the dentin layer. These teeth are typically tender to the touch and to

air exposure. A yellow layer of dentin may be visible on examination.

llis $lass III

&rown fracture with pulp exposure: These fractures involve the enamel, dentin, and pulp layers.

These teeth are tender similar to those in the llis II category" and have a visible area of pink,

red, or even blood at the center of the tooth.

llis $lass I

Traumati'ed tooth that has become non3vital with or without loss of tooth structure.

llis $lass

4uxation: The effect on the tooth that tends to dislocate the tooth from the alveolus.

Teeth loss due to trauma.

llis $lass I

Avulsion: The complete separation of a tooth from its alveolus by traumatic in$ury.

1racture of root with or without loss of crown structure.


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llis $lass II

Displacement of a tooth without the fracture of crown or root.

llis $lass III

1racture of the crown en masse and its replacement.

llis $lass I)

1racture of deciduous teeth.

21. :aination; Dia+nosis and 'reatent

a< namel 1racture

=a< b"

1igure : namel fracture a", b"

Source : https://www.rickwilsondmd.typepad.com (a)https://www.aofoundation.org (b)

Description A fracture confined to the enamel with loss of tooth

structure.

5isual signs 5isible loss of enamel. #o visible sign of exposed dentin.

%ercussion test #ot tender. If tenderness is observed evaluate the tooth for

a possible luxation or root fracture in$ury.


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6obility test #ormal mobility.

7ensibility pulp test sually positive. The test may be negative initially

indicating transient pulpal damage. 6onitor pulpal

response until a definitive pulpal diagnosis can be made.

The test is important in assessing risk of future healing

complications. A lack of response at the initial examination

indicates an increased risk of later pulp necrosis.

8adiographic findings The enamel loss is visible.

8adiographs

recommended

%eriapical, occlusal and eccentric exposures. They are

recommended in order to rule out the possible presence of a

root fracture or a luxation in$ury.

Treatment :

If a tooth fragment is available, it can be bonded to the tooth. 9rinding or restoration with

composite resin depending on the extent and location of the fracture. 1ollow up by clinical and

radiographic control at !3 weeks and ; year.

b" namel3Dentin 1racture

a" b"1igure : namel3dentin fracture a", b"

Source : https://www.intelligentdental.com (a)

https://www.aofoundation.org (b)

Description A fracture confined to enamel and dentin with loss of tooth

https://www.intelligentdental.com/https://www.intelligentdental.com/https://www.intelligentdental.com/https://www.intelligentdental.com/


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structure, but not involving the pulp.

5isual signs 5isible loss of enamel and dentin. #o visible sign of

exposed pulp tissue.


possible luxation or root fracture in$ury.


7ensibility pulp test sually positive. The test may be negative initially

indicating transient pulpal damage. 6onitor pulpal

response until a definitive pulpal diagnosis can be made.

The test is important in assessing future risk of healing

complications. A lack of response at the initial examination

indicates an increased risk of later pulp necrosis.

8adiographic findings The enamel3dentin loss is visible.

8adiographs

recommended

%eriapical, occlusal and eccentric exposure. They are

recommended in order to rule out displacement or the

possible presence of a root fracture.

8adiograph of lip or cheek lacerations to search for tooth

fragments or foreign material.

Treatment :

If a tooth fragment is available, it can be bonded to the tooth. (therwise perform a provisional

treatment by covering the exposed dentin with glass3ionomer or a permanent restoration using a


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bonding agent and composite resin. The definitive treatment for the fractured crown is

restoration with accepted dental restorative materials. 8adiograph of lip or cheek lacerations to

search for tooth fragments or foreign material. 1ollow up by clinical and radiographic control at

!3 weeks and ; year.

c" namel3Dentin3%ulp 1racture

a" b"

1igure : namel3dentin3pulp fracture a", b"Source : https://www.michelle.sisnetusa.com (a)

https://www.aofoundation.org (b)

Description A fracture involving enamel and dentin with loss of toothstructure and exposure of the pulp.

5isual signs 5isible loss of enamel and dentin and exposed pulp tissue.


luxation or root fracture in$ury.


7ensibility test sually positive. The test is important in assessing risk of

future healing complications. A lack of response at the

initial examination indicates an increased risk of later pulp

necrosis.

8adiographic findings The loss of tooth substance is visible.


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8adiographs

recommended

%eriapical, occlusal and eccentric exposure. They are

recommended in order to rule out displacement or the

possible presence of a luxation or a root fracture.

8adiograph of lip or cheek lacerations to search for toothfragments or foreign material.

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. This treatment is also the

treatment of choice in patients with closed apices. &alcium hydroxide compounds and 6TA

white" are suitable materials for such procedures. In older patients with closed apices and an

associated luxation injury with displacement , root canal treatment is usually the treatment of

choice. 1ollow up by clinical and radiographic control at !3 weeks and ; year.

d" &rown38oot 1racture without %ulp Involvement ncomplicated"

1igure : ncomplicated crown3root fracture


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Source : https://www.avdc.org

Description A fracture involving enamel, dentin and cementum with

loss of tooth structure, but not exposing the pulp.

5isual signs &rown fracture extending below gingival margin.

%ercussion test Tender.

6obility test &oronal fragment mobile.

7ensibility pulp test sually positive for apical fragment.

8adiographic findings Apical extension of fracture usually not visible.

8adiographs

recommended

%eriapical, occlusal and eccentric exposures. They are

recommended in order to detect fracture lines in the root. A

cone beam exposure can reveal the whole fractureextension.

Treatment :

Depending on the clinical findings, six treatment scenarios may be considered. 6ost of these

may be deferred to later treatment.

• Fra+ent reoval onl!

8emoval of a superficial coronal crown3root fragment and subse


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• >rt%odontic e:trusion o aical ra+ent

8emoval of the coronal segment with subse" may offter a better

position for periodontal ligament healing. 0ecause the fracture site becomes exposed

labially and thereby more periodontal ligament can be saved.

• Decoronation =5oot su?er+ence<

Implant solution is planned, the root fragment may be left in situ after in order to avoid

alveolar bone resorption and thereby maintaining the volume of the alveolar process for

later optimal implant installation.

• :traction

xtraction with immediate or delayed implant3retained crown restoration or a

conventional bridge. xtraction is inevitable crown3root fractures with a severe apical

extension, the extreme being a vertical fracture.

%atient is instructed to only have soft food for ; week. 9ood healing following an in$ury to the

teeth and oral tissues depends, in part, on good oral hygiene. 0rushing with a soft brush and

rinsing with chlorhexidine >.; ? is beneficial to prevent accumulation of pla


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e" &rown38oot 1racture with %ulp Involvement &omplicated"

1igure : &omplicated crown3root fracture

Source : https://www.dentaltraumaguide.org

Description A fracture involving enamel, dentin, and cementum with

loss of tooth structure, and exposure of the pulp.

5isual signs &rown fracture extending below gingival margin.

%ercussion test Tender.

6obility test &oronal fragment mobile.

7ensibility test sually positive for apical fragment.

8adiographic findings Apical extension of fracture usually not visible.

8adiographs

recommended

%eriapical and occlusal exposure. A cone beam exposure

can reveal the whole fracture extension.

Treatment :

• 1ragment removal and gingivectomy sometimes ostectomy"

• (rthodontic extrusion of apical fragment

• 7urgical extrusion

https://www.dentaltraumaguide.org/https://www.dentaltraumaguide.org/https://www.dentaltraumaguide.org/


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• Decoronation 8oot submergence"

• xtraction

%atient instructions and follow up are similar as for crown3root fracture without pulp

involvement.

f" 8oot 1racture

1igure : 8oot fracture

Source : https://www.aofoundation.org

Description A fracture confined to the root of the tooth involving

cementum, dentin, and the pulp. 8oot fractures can be

further classified by whether the coronal fragment is

displaced.

5isual signs The coronal segment may be mobile and in some cases

displaced. Transient crown discoloration red or grey" may

occur. 0leeding from the gingival sulcus may be noted.

%ercussion test The tooth may be tender.

6obility test The coronal segment may be mobile.

7ensibility pulp test 7ensibility testing may give negative results initially,

indicating transient or permanent neural damage.


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6onitoring the status of the pulp is recommended.

The pulp sensibility test is usually negative for root

fractures except for teeth with minor displacements. The

test is important in assessing risk of healing complications.

A positive sensibility test at the initial examination

indicates a significantly reduced risk of later pulp necrosis.

8adiographic findings The root fracture line is usually visible. The fracture

involves the root of the tooth and is in a hori'ontal or

diagonal plane.

8adiographs

recommended

%eriapical, occlusal and eccentric exposures.

An occlusal exposure is optimal for locating root fractures

in the apical and middle third. 0isecting angle exposure or

=>o degree angulation exposure is needed to locate the

fractures in the cervical third of the root.

Treatment :

• 8inse exposed root surface with saline before repositioning. If displaced, reposition the

coronal segment of the tooth as soon as possible.

• &heck that correct position has been reached radiographically.


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• 7tabili'e the tooth with a flexible splint for @ weeks. If the root fracture is near the

cervical area of the tooth, stabili'ation is beneficial for a longer period of time up to @

months".

• 6onitor healing for at least ; year to determine pulpal status. If pulp necrosis develops,

then root canal treatment of the coronal tooth segment to the fracture line is indicated.

%atient instructed to have soft food for ; week. 9ood healing following an in$ury to the teeth and

oral tissues depends, in part, on good oral hygiene. 0rushing with a soft brush and rinsing with

chlorhexidine >.; ? is beneficial to prevent accumulation of pla


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follow3up if the tooth still does not respond to electrometric or thermal pulp testing and if

radiographs show a radiolucency next to the fracture line.

22'oot% Discoloration

221 Deinition

• Ingle defines tooth discoloration as any changes in the hue, colour or translucency of a

tooth due to any cause such as restorative filling materials, drugs both topical B

systemic", pulpal necrosis or hemorrhage may be responsible. Tooth discoloration also

known as CDarkening of Teeth. Teeth become discoloured by stains on the tooth surface.

A stain is a discoloured spot or area.Tooth discoloration can occur on the outer layer of

the tooth, enamel or on the inner layer of the tooth, dentin.

222 tiolo+!

• Tooth discoloration can be caused by certain foods and drinks, poor dental hygiene,

smoking or chewing tobacco, caries means cavities, certain infectious in pregnant

mothers, several disease that can affect enamel and dentin, dental product used in

dentistry, certain medications, excessive fluoride, trauma and normal aging

223 '!es

There are three types of tooth discoloration. 1irstly, extrinsic stains. This occurs when the outer

layer of the tooth meant the enamel is stained. &offee, wine, cola or other drinks or foods can

stain teeth. 7moking also causes extrinsic stains.

#ext is intrinsic stains. This is when the inner structure of the tooth the dentin" darkens or gets a

yellow tint. Eou can get this type of discoloration if, patient had too much exposure to fluoride

during early childhood. %regnant women used tetracycline antibiotics during the second half of

pregnancy. %atient used tetracycline antibiotics when you were years old or younger. %atient


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had trauma that affected a tooth when you were a young child. A fall, for example, may damage

the developing permanent tooth. %atient had trauma in a permanent tooth, and internal bleeding

discolored the tooth. 4astly,patient were born with a rare condition called dentinogenesis

imperfecta. This causes gray, amber or purple discolorations.

4ast but not least is age3related. This is a combination of extrinsic and intrinsic factors. Dentin

naturally yellows over time. The enamel that covers the teeth gets thinner with age, which allows

the dentin to show through. 1oods and smoking also can stain teeth as people get older. 1inally,

chips or other in$uries can discolor a tooth, especially when the pulp has been damaged

22. 'reatent

A healthy smile improves self images and confidence and indicates good overall health. Today

dentists have many treatment modalities to improve the appearance of smile.

7uperficial stains or extrinsic stains are removed by simple professional scale and polish done by

the dentist. An ultrasonic scaler is used to remove the stains and polishing is done with pumice.

Deep embedded stains or intrinsic stains cannot be removed by scale and polish techni


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color is made lighter. As a result of bleaching there may be temporary tooth sensitivity to heat

and cold and gum irritation may be present.

In the case of inherited or developmental stains, these types of stains cannot be removed by teeth

whitening. In such cases veneers and composite bonding may be the only option. &omposite

bonding, in this procedure, plastic material or resin material which matches the color of the tooth

is applied. It is then bonded onto the tooth using a special kind of light. (ther treatment is

veneers. In this treatment a thin wafer like tooth colored material known as porcelain veneer or

porcelain laminate is designed to cover the front portion of the teeth.

%rognosis for extrinsic stains is good. Intrinsic stains however may be more difficult or take

longer to remove.

23 $ro&n

231 Deinition

A crown is an artificial restoration that fits over the remaining part of a prepared tooth, 3 to cover

the tooth to restore its shape and si'e, strength, and improve its appearance. The crowns, when

cemented into place, fully encase the entire visible portion of a tooth that lies at and above the

gum line. 1or anterior teeth, they are sometimes termed as F$acket while for posterior teeth, they

are termed as Fcrown.

1igure ;. %osterior &rown. Source : www.doctoradrian.com"

http://www.webmd.com/oral-health/dental-care-smile-10/slideshow-pretty-teethhttp://www.webmd.com/oral-health/dental-care-smile-10/slideshow-pretty-teethhttp://www.webmd.com/oral-health/rm-quiz-what-do-you-know-about-your-teethhttp://www.webmd.com/oral-health/rm-quiz-what-do-you-know-about-your-teethhttp://www.webmd.com/oral-health/rm-quiz-what-do-you-know-about-your-teethhttp://www.doctoradrian.com/services/cosmetic-dentistry/crowns/http://www.webmd.com/oral-health/dental-care-smile-10/slideshow-pretty-teethhttp://www.webmd.com/oral-health/rm-quiz-what-do-you-know-about-your-teethhttp://www.doctoradrian.com/services/cosmetic-dentistry/crowns/


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232 Indication

;. To protect a weak tooth from breaking or to hold together parts of a cracked tooth.

-. To restore an already broken tooth or a tooth that has been severely worn down.

G. To cover and support a tooth with a large filling when there isn2t a lot of tooth left.

@. To hold a dental bridge in place.

. To cover misshapened or severely discolored teeth.

!. To cover a dental implant or endodontic treatment.

H. To make a cosmetic modification.

1igure -. 0efore and after anterior teeth restoration using porcelain $ackets. (Source: r. !ark

"ilelo www.houmacomprehensivedentistry.com )

http://www.webmd.com/oral-health/tc/chipped-or-broken-tooth-or-dental-appliance-creditshttp://www.webmd.com/oral-health/guide/dental-health-bridgeshttp://www.webmd.com/oral-health/guide/dental-health-bridgeshttp://www.webmd.com/oral-health/guide/dental-implantshttp://www.webmd.com/oral-health/guide/dental-implantshttp://www.google.com/url?sa=i&source=imgres&cd=&cad=rja&uact=8&ved=0CAgQjB0wAGoVChMIiLjn06O9yAIVQQiOCh1uMwOz&url=http%3A%2F%2Fwww.houmacomprehensivedentistry.com%2Fservices%2Fdental-crowns-houma%2F&psig=AFQjCNEX3BEmteMqY6f7tKzy1PG3nV4MGw&ust=1444751170783490http://www.webmd.com/oral-health/tc/chipped-or-broken-tooth-or-dental-appliance-creditshttp://www.webmd.com/oral-health/guide/dental-health-bridgeshttp://www.webmd.com/oral-health/guide/dental-implantshttp://www.google.com/url?sa=i&source=imgres&cd=&cad=rja&uact=8&ved=0CAgQjB0wAGoVChMIiLjn06O9yAIVQQiOCh1uMwOz&url=http%3A%2F%2Fwww.houmacomprehensivedentistry.com%2Fservices%2Fdental-crowns-houma%2F&psig=AFQjCNEX3BEmteMqY6f7tKzy1PG3nV4MGw&ust=1444751170783490


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1igure G. G3unit Dental 0ridge. (Source:www.wawaseefamilydentistry.com )

1igure @. 0efore and after cosmetic restoration using $ackets and crowns on the whole lower $aw.

(Source: www.hubertydental.com )

1igure . 0efore and after cosmetic restoration using $ackets on anterior maxillary teeth.

(Source: www.drsellinger.com )

233 '!es

In 'ers o Suort

'oot% Suort

Teeth with enough tooth support will be prepared to receive the crowns. The 7upport for the

crown is provided by the tooth itself.

http://www.wawaseefamilydentistry.com/sed-ut-perspiciatis-unde-omnis-iste/sed-diam-nonummy-nibh-euismod-tincidunt-ut-laoreet/http://www.hubertydental.com/crowns.htmlhttp://www.hubertydental.com/crowns.htmlhttp://www.drsellinger.com/crowns.phphttp://www.wawaseefamilydentistry.com/sed-ut-perspiciatis-unde-omnis-iste/sed-diam-nonummy-nibh-euismod-tincidunt-ut-laoreet/http://www.hubertydental.com/crowns.htmlhttp://www.drsellinger.com/crowns.php


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1igure !. %reparation for posterior crown on premolar . (Source: teethgeek.com )

1igure H. %reparation of posterior teeth. (Source: #$eel %eshamvala )

Post/ $ore Suort

In root3filled teeth it may be necessary to insert a post into the tooth root before placing a crown.

A post gives support and helps the crown to stay in place. The surface of the tooth may be

removed down to the level of the gum. A post can be made of prefabricated stainless steel which

the dentist can fit directly into the root canal. (r a custom3made post can be constructed by a

dental technician to accurately fit the shape of the prepared root canal. The post is placed into the

root canal and cemented in position, ready for the crown to be attached.

http://teethgeek.com/crowns-revision-part-2/http://teethgeek.com/crowns-revision-part-2/http://www.youtube.com/watch?v=OcfSaRrDGMAhttp://teethgeek.com/crowns-revision-part-2/http://www.youtube.com/watch?v=OcfSaRrDGMA


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1igure . %repared and cemented core in an endodontically treated tooth. (Source:

www.schweit&erdental.com )

http://www.schweitzerdental.com/expertise/expertise-02/post-and-cores/http://www.schweitzerdental.com/expertise/expertise-02/post-and-cores/


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In 'ers o ,aterial

%ermanent crowns can be made from stainless steel, all metal such as gold or another alloy",

porcelain3fused3to3metal, all resin, or all ceramic.

• Stainless steel crowns are prefabricated crowns that are used on permanent teeth

primarily as a temporary measure. The crown protects the tooth or filling while a

permanent crown is made from another material. 1or children, a stainless steel crown is

commonly used to fit over a primary tooth that2s been prepared to fit it. The crown covers

the entire tooth and protects it from further decay. +hen the primary tooth comes out to

make room for the permanent tooth, the crown comes out naturally with it. In general,

stainless steel crowns are used for children2s teeth because they don2t re


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1igure ;;. %orcelain3fued3to3metal crown. (Source: www.a'dentallab.com )

• All@resin dental crowns are less expensive than other crown types. )owever, they wear

down over time and are more prone to fractures than porcelain3fused3to3metal crowns.

1igure ;-. All3resin crown. (Source: www.bloubergdental.co.&a )

• All@ceraic or all@orcelain dental crowns provide better natural color match than any

other crown type and may be more suitable for people with metal allergies. )owever,

they are not as strong as porcelain3fused3to3metal crowns and they wear down opposing

teeth a little more than metal or resin crowns. All3ceramic crowns are a good choice for

front teeth.

http://www.a-1dentallab.com/?page_id=84http://www.a-1dentallab.com/?page_id=84http://www.webmd.com/a-to-z-guides/understanding-fractures-basic-informationhttp://www.webmd.com/a-to-z-guides/understanding-fractures-basic-informationhttp://www.bloubergdental.co.za/Crowns.htmlhttp://www.webmd.com/allergies/default.htmhttp://www.webmd.com/allergies/default.htmhttp://www.a-1dentallab.com/?page_id=84http://www.webmd.com/a-to-z-guides/understanding-fractures-basic-informationhttp://www.bloubergdental.co.za/Crowns.htmlhttp://www.webmd.com/allergies/default.htm


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1igure ;G. All3porcelain bridge. (Source: www.drchetan.com )

• 'eorar! versus eranent Temporary crowns can be made in your dentist2s office,

whereas permanent crowns are made in a dental laboratory. Temporary crowns are made

of acrylic or stainless steel and can be used as a temporary restoration until a permanent

crown is constructed by a lab.

1igure ;@. Temporary crowns. (Source: www.smartpractice.com )

•

(irconia or illed cro&n which are digitally constructed either in an office that has thesoftware and hardware to produce them or in a dental lab. Dental offices that have the

software and hardware have the ability to produce a crown in one visit with no need for a

temporary. These crowns re


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1igure ;. irconia crown and bridge. (Source: www.glidewelldental.com )

23. $otraindication

1 General conditions t%at a7e anest%esia or toot% rearation inadvisa?le

These include: serious heart diseases, recent strokes and others. These situations re minutes to

an hour. During the time period about two weeks" between the two appointments, a dental

http://www.glidewelldental.com/lab/services/prismatik-cz.aspxhttp://www.infodentis.com/tooth-decay/tooth-restoration.html#direct-restorationhttp://www.infodentis.com/tooth-decay/tooth-restoration.html#direct-restorationhttp://www.infodentis.com/tooth-decay/tooth-restoration.html#inlayhttp://www.infodentis.com/cosmetic-dentistry/veneers.htmlhttp://www.glidewelldental.com/lab/services/prismatik-cz.aspxhttp://www.infodentis.com/tooth-decay/tooth-restoration.html#direct-restorationhttp://www.infodentis.com/tooth-decay/tooth-restoration.html#inlayhttp://www.infodentis.com/cosmetic-dentistry/veneers.html


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laboratory will fabricate the crown. +hen the patient returns for their second visit, dentist will

cement finished crown into place. This usually completed in about -> minutes or so.

Initial Aointent

1 *u?in+ t%e toot%

Anestheti'e both tooth and gum tissue that surrounds it. #umbing is not needed if there is

root canal treatment.

2 Prearin+ =S%ain+< t%e toot%

a" A specific amount of tooth structure must be trimmed away

All crowns need to have a certain minimal thickness to insure ade


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3 'a7in+ iression o reared toot% @ &onventional dental impressions

6ost dentists will take an impression of your tooth using a paste or putty3like compound

that referred as *impression material.*

a. The prepared tooth is washed and dried

b. 8etraction cord is tucked around the tooth in the space between it and its

surrounding gum tissue

c. A small amount of runny impression material is s


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Source: #nimate'eeth.com

Dentist will $udge what shade of ceramic most closely matches your tooth2s neighboring

teeth using shade guide a series of small, tooth3shaped pieces of dental porcelain, each one

having a different color".

$ro&n Placeent Aoinent

1 5eove teorar! cro&n

Temporary crown is removed and remnants of temporary cement that remain on your

tooth is cleaned.

2 valuate t%e it and aearance o t%e cro&n

a" &hecking the fit

Dentist will seat the crown on tooth and inspect that it fits possibly by using dental floss,

feeling it with a dental tool, or asking patient to bite down gently".

b" &hecking the appearance

Dentist will likely hand patient a mirror and ask to evaluate the crown2s overall shape and

color.


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%ulp testing is often referred to as vitality testing. %ulp vitality tests play an important role in

diagnosis because these tests not only determine the vitality of tooth but also the pathological

status of pulp. The dentist should include control teeth of similar type for the first application of

any test, to establish a baseline for response. The patient should not be told beforehand.

7ome pulp testing techni


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2. 5adio+ra%ic e:aination

8adiographic examination allows identification of:

• %resence of caries that may involve or threat to involve pulp

•

6ay show the number ,curve, length and width of root canals• %resence of calcified materials in the pulp chamber or root canals

• 8esorption of dentin

• Thickening of %D4

• 6aturity and extent of periapical and alveolar bone destruction

http:JJwww.slideshare.netJdrKm'sJdiagnostic3procedures3;;=->-LrelatedM;

&hapter G: &ase 8eport

G.;Anamnesis

G.- xamination

&hapter @:Discussion

@.;Treatment

@.- &onclusion

http://www.slideshare.net/dr_mzs/diagnostic-procedures-11925025?related=1http://www.slideshare.net/dr_mzs/diagnostic-procedures-11925025?related=1


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dsp 9 case 5 tooth fracture

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