Lorna Gladwin BDS, MFDS RCSEng, PGCertClinical Dentist in Restorative Dentistry, University Dental Hospital of Manchester, Manchester, UK.
James Darcey BDS, MSc, MDPH, MFGDP, MEndo, FDS Rest Dent RCSEd Consultant and Honorary Lecturer in Restorative Dentistry, University Dental Hospital of Manchester, Manchester, UK.
Prim Dent J. 2023 Dec;12(4):72-82. doi: 10.1177/20501684231213908.
Traumatic dental injuries pose a variety of complex ongoing issues to the dental practitioner. As dental injuries are commonly experienced at a young age, the treatment often takes place during adolescence or early in adulthood years at crucial development stages and very early in the life of the permanent successor. Therefore, the ability to correctly diagnose the injury, and follow an appropriate management plan should increase practitioners' ability to improve both the outcomes of dental trauma and long-term prognosis of the tooth.The consequences of dental trauma can be explored by taking into consideration the type of injury, which enables an assessment of the degree of insult to the pulpal tissues, neurovascular bundle, periodontal ligament and cemental cells. This has a direct influence on post-trauma complications. Early intervention, where indicated, and appropriate follow-up utilising international guidelines is imperative to identify changing diagnoses and act accordingly. This review paper will discuss the classification of traumatic injuries and their associated outcomes with management strategies for emerging disease including potential endodontic and restorative complexities and when to refer to secondary care.
创伤性牙损伤给口腔医生带来了一系列复杂的问题。由于牙损伤通常发生在年轻时期,因此治疗通常在青少年时期或成年早期进行,此时正值关键的发育阶段,并且是恒牙萌出的早期阶段。因此,正确诊断损伤并遵循适当的管理计划应提高医生改善牙外伤治疗效果和牙齿长期预后的能力。通过考虑损伤类型,可以探讨牙外伤的后果,从而评估牙髓组织、神经血管束、牙周膜和牙骨质细胞的损伤程度。这直接影响外伤后的并发症。早期干预(如有指征)和适当的后续治疗,利用国际指南识别诊断变化并采取相应措施,对于确定改变的诊断并采取相应的措施是至关重要的。本文将讨论创伤性损伤的分类及其与管理策略相关的结果,包括新兴疾病(包括潜在的牙髓病和修复复杂性)的管理策略,以及何时需要转至二级医疗。