Intrusive injuries of traumatic origin
Traumatic lesions are usually very common in child or temporary dentition, so they currently constitute one of the main reasons of anpediatric dental consultation. Dental trauma in temporary dentition are an important problem in dentistry, which have medical, aesthetic and psychological consequences for children and frequently for their parents.
As we have said, trauma are everyday events in children, especially in the first three years of life, because motor coordination is developing and the child’s intellectual development makes it an inability to evaluate risks of their activities. There is also difficulty of cooperation of the small child towards dental treatment, which does not justify the abstention of treatment.
They are the emergencies in dentistry that cause greater emotional and psychological impact on parents and the child. Parents care about the consequences of the coup, but especially for the aesthetic consequences that trauma can cause, since in most cases the superior segment is affected. Both the patient and his parents usually reach the consultation very scared. The dentist must try to calm them. Anxiety is relieved often offering security.
The management of dental trauma in temporal dentition is different from that recommended in permanent teeth. It should be borne in mind that there is a close relationship between the apex of the injured temporary tooth and the underlying permanent dental germ, which can cause serious long -term consequences. Therefore, it forces to follow up, from the injured area, for several years until the affected temporal teeth are exfolian and the corresponding permanent ones come out totally. Due to the big sequelae, the selected treatment should avoid any maneuver that could damage, even more, to the permanent successors.
Among the consequences that may take place on the definitive teeth, it is worth highlighting morphological anomalies and/or in the process of dentontogenesis, which can affect the crown, root or also produce alterations of the eruption.
Traumatic lesions frequently observed in pediatric patients are the result of impacts, whose aggressive force exceeds the resistance of bone, muscular and dental tissues. The extension of these lesions maintains a direct relationship with the intensity, type and duration of the impact. That is, as these three factors increase, the greater the damage caused by trauma.
Unlike what happens in permanent dentition, the most frequent lesions are those that affect the periodontal ligament and support tissues and to a lesser extent coronary fractures. This is due to the different characteristics of the periodont, since, in the temporal dentition, the bone is less dense and less mineralized and, therefore, has greater ease to injure. This implies a severe risk of impact of the apex of the temporary tooth in the structures of the permanent tooth that is being formed.
Intrusion is possibly the traumatic lesion that produces the greatest insult on the affected tooth and its support tissues. The displacement within the alveolus causes an extensive and acute affectation of the periodontal ligament, bone lesions due to compression of the alveolus, breakage of the neurovascular trunk5 and in many of the reported cases it affects the dental germ in development. Constitutes 4.4% to 22% of traumatic lesions in oral cavity (8.9). Statistically the most involved teeth in this type of dislocation are the primary upper incisors in 93.47% of cases, considering the incisive primary right central (51), the most affected tooth of the arc (41.3% of cases of cases).