Leczenie implantoprotetyczne po urazie w strefie estetycznej

Discussion

Dental injuries seldom involve a single tooth; therefore, the treatment scheme of an isolated injury is not always proper for adjacent teeth. Achieving and maintaining satisfactory outcomes in the treatment of dental injuries is a challenge for the dentist and often requires interdisciplinary cooperation between specialists. In the case described above, the patient required conservative, endodontic, prosthetic, and surgical implantology treatment. In the treatment of tooth fractures without pulp exposure, such as the injury to tooth 37 described in the patient, satisfactory aesthetic and functional outcomes can be achieved with minimum preparation of the fracture edges and the application of bonding systems and composite materials (5, 11, 13–14). In the treatment of fractured tooth crowns with exposed pulp various procedures can be applied, depending on the size of the exposure, time elapsed between the injury and providing aid to the patient, state of the pulp, the state of the periapical tissues, the hygienic state of oral cavity, and other concomitant injuries which may impair the healing of the pulp. The treatment options in adults include direct pulp capping, extirpation of pulp under anaesthesia, and aseptic endodontic treatment. Direct pulp capping with calcium hydroxide or MTA is possible when the patient reports to the dentist within 2 hours from injury, the surface of the exposure is small, the pulp reacts normally, and the oral hygiene is good (3, 5, 12, 14). In other cases extirpation of pulp under anaesthesia is indicated or, if the pulp vitality is lost, antiseptic endodontic treatment. According to Arabska-Przedpełska and Asgara (3, 12), in adult patients extirpation in anaesthesia is preferable due to the decreased regenerative properties of pulp and the larger failure percentage of direct capping. Further treatment in this kind of injuries involve...