Leczenie implantoprotetyczne po urazie w strefie estetycznej

Post-injury implantoprosthetic treatment in the aesthetic zone

Injuries to the teeth and surrounding tissues are among the most frequent craniofacial injuries (from about 4 to even 33% according to Lewandowski, about 4.5% according to Lam). They are usually observed in children and youth; in adults, the majority of accidents resulting in damage to the teeth occurs between 21 and 30 years of age. In mature persons, traumatic injuries to the teeth are found mainly in men, which is associated with practicing contact sports and a tendency to aggressive behaviour (according to Arabska-Przedpełska, for the age range of 19–21 the causes of injuries are sport and fighting, and communication accidents for the range above 23) (1-4). According to Andreasen, in adults the injuries are caused by prodding or striking and usually occur during leisure time (5). Predisposing factors for injury also include: malocclusion (e.g. excessive overjet), overweight and obesity, and diseases such as epilepsy (6-7). The injuries usually involve upper anterior teeth, followed by lower teeth; they may also involve lateral teeth (3, 8). Deciduous teeth injuries are more often associated with the damage to surrounding tissue, whereas in the case of permanent teeth they usually involve teeth alone. It is related to anatomical conditions: deciduous teeth are surrounded by a small amount of flexible bony tissue, which makes them easier to knock out. The rigid connection between permanent teeth and a larger amount of bony tissue leads to crown and root fractures during trauma (9). The earliest and most frequently used classification of traumatic tooth injuries is Ellis classification. He divided the damage to teeth into 9 classes: I – crown fracture through enamel, II – crown fracture through enamel and dentin, III – crown fracture with pulp exposure, IV – trauma leading to the loss of pulp vitality, with or w...