Chatzidimitriou Konstantina, Lygidakis Nikos N, Lygidakis Nick A
J Clin Pediatr Dent. 2017;41(5):327-331. doi: 10.17796/1053-4628-41.5.327.
Alveolar fractures treatment includes repositioning of displaced segments and splinting. In children, splinting procedures may occasionally present clinical problems resulting from fewer teeth available for splinting or presence of occlusal disturbances. An alternative clinical approach for splinting in alveolar fractures of primary dentition is described.
A 4.5-year-old girl was referred to our clinic 8 hours after a fall accident. Clinical examination revealed mandibular alveolar process segmental fracture in the right canine area with frontal dislodgement of the labial cortical bone resulting to occluding inability. The area was anaesthetized, cleaned and the dislodged bone was manually repositioned, followed by an EVA copolymer splint for fixation as a result of patient's deep bite impeding regular wire-composite splint. The cap splint that was fabricated on a cast made after an alginate impression, was set on the mandibular dentition and immobilized in the primary molars with acid-etch adhesive and flowable resin composite. Following splint removal after 4 weeks and follow-up visits, successful healing was observed clinically and radiographically with no pathological signs and symptoms.
The described alternative splinting method in alveolar fractures of primary dentition is a valuable clinical tool for peediatric dentists, easily accepted by children in cases where regular splinting methods cannot be used.
牙槽骨骨折的治疗包括复位移位节段和固定。在儿童中,固定操作偶尔会因可用于固定的牙齿较少或存在咬合紊乱而出现临床问题。本文描述了一种在乳牙列牙槽骨骨折中进行固定的替代临床方法。
一名4.5岁女孩在跌倒事故8小时后被转诊至我院。临床检查发现右尖牙区下颌牙槽突节段性骨折,唇侧皮质骨向前移位,导致无法咬合。对该区域进行麻醉、清洁,手动复位移位的骨块,由于患者深覆牙合妨碍常规钢丝-复合树脂固定,随后采用乙烯-醋酸乙烯共聚物夹板进行固定。在藻酸盐印模后制作的模型上制作的帽状夹板,放置在下颌牙列上,并用酸蚀粘合剂和流动树脂复合材料固定在乳磨牙上。4周后拆除夹板并进行随访,临床和影像学观察均显示愈合成功,无病理体征和症状。
本文所述的乳牙列牙槽骨骨折替代固定方法是儿科牙医的一种有价值的临床工具,在无法使用常规固定方法的情况下,儿童易于接受。