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Avulsion of a tooth requires decisive action by the dental practitioner. Replantation of the tooth at the earliest possible time, along with the avoidance of further periodontal damage, is paramount to achieving a successful result. The accident site, time the tooth is out of the socket, storage media and endodontic protocol influence the prognosis. Appropriate endodontic management and tooth restoration will ensure long-term success.
The effect of occlusion on periodontal disease has long been controversial. There are a few studies showing the benefit of occlusal therapy in the treatment of periodontal disease. This paper discusses these studies in an effort to give guidelines for treatment of occlusal trauma and its relationship to periodontal therapy.
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The position of the anterior teeth and skeletal base relationship establish many of our facial characteristics, yet these same tooth positions can result in a range of dental problems that are often specific for a particular incisal relationship. Excessive loss of tooth tissue on various surfaces may result in trauma to the soft tissue and temporomandibular joint dysfunction. A range of treatment options may be required and can often be conveniently classified by the form of incisal relationship.
Proper management of permanent incisors with horizontal root fractures includes careful diagnosis, continued re-evaluation and a conservative treatment approach. The location of the root fracture and pulpal vitality status both play important roles in proper treatment decisions. A thorough examination, judicious treatment and follow-up on the part of both dentist and patient can result in long term retention of many of these traumatized teeth.
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The objectives of an ideal direct restoration include pulpal health, biocompatibility, occlusal stability, anatomical restitution, marginal perfection, and interproximal integrity. While tooth-colored composites have replaced amalgam as the restorative material of choice for many dental professionals, the utilization of composite materials of two different viscosities has proven effective in increasing strength and adaptation, and facilitating placement of anterior and posterior restorations. Several newly enhanced composite combinations have begun to allay reservations about directly placed tooth-colored restorations. This article classifies the ideal handling characteristics and benefits of a recently introduced, direct Ceromer system (Tetric Flow and Tetric Ceram, Ivoclar Vivadent, Amherst, NY.)
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This article presents an understanding of the mechanical response of polymer matrix composite materials that are reinforced with fibers that have high levels of failure strain. Also discussed are the basic principles for the use of the materials and techniques to optimize the clinical success for the applications in which these fibers are used to restore and maintain form and function to the masticatory structures.
Thorough evaluation and correct treatment of traumatized teeth improve their chances for survival. This article provides an overview clinical evaluation and how best to treat the tooth that has been traumatized. The rationale and techniques for tooth stabilization of the traumatized tooth will also be presented.
Elimination of lesions diagnostic of trauma from occlusion is an essential part of complete periodontal therapy and restoration of health in the masticatory system for such patients. This can be achieved by orthodontic treatment, temporary splinting, bite-planes, occlusal adjustment and permanent splinting of teeth. Occlusal therapy may be required during periodontal treatment for trauma from occlusion and to enhance occlusal stability at any stage of periodontitis, but is most often needed in advanced periodontitis. Splinting of hypermobility of self-limiting trauma from occlusion is not indicated. Splinting may be required in addition to occlusal adjustment in moderate to severe periodontitis when trauma from occlusion is progressive.
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