FRAKTUR

DENTOALVEOLAR

Drg YAYUN SITI ROCHMAH SpBM

 FRAKTUR
DENTOALVEOL
FRAKTUR
AR RAHANG
FRAKTUR
DENTAL

FRAKTUR
DENTOALVEOLAR
 • SUBLUKSASI
FRAKTUR • LUKSASI
DENTOALVEO • DISLOKASI
LAR • FRAKTUR
MAHKOTA
• INTRUSI
• EKSTRUSI
• AVULSI
 FRAKTUR DENTAL

RO
 LATERO MEDIAL
EKSTRUSI INTRUSI VERSI atau
LABIOLINGUAL
VERSI
ETIOLOGI

 KECELAKAAN
 KDRT
 IATROGENIK
AKIBAT TRAUMA
 KERUSAKAN JARINGAN KERAS GIGI
(FRAKTUR MAHKOTA)
 KERUSAKAN
PERIODONTAL(SUBLUKASASI,
INTRUSI, EKSTRUSI ,DSB)
 KERUSAKAN TULANG ALVEOLAR(
INTRUSI GIGI DENGAN FRAKTUR
SOCKET )
 KERUSAKAN GINGGIVA (KONTUSI,
ABRASI, LASERASI )
 KOMBINASI
PREDELEKSI
 Karakteristik fraktur dentoalveolar
Injury Description Findings Management Prognosis
Minor impact. Slight
bruising and oedema. Painful: +. Not wobbly. Very good. <5% pulp
Contussion Standard (see notes)
Little disruption to Bleeding: none. death.
pulp/nerves.
Suture lacerations. May Good. 10% pulp death
Minor impact.
Painful: ++. Wobbly: +. need to file opposition at 5 years. (If tooth is
Disruption to supporting
Subluxation Bleeding: Gum margin tooth if it causes pain on insensitive at time of
structures (periodontal
+. biting. Consider injury, risk increases to
ligament).
splinting for comfort. 25%)
Moderate transverse
impact. Very wobbly
Clean any exposed tooth
but has not left socket. Painful: ++. Wobbly:
and suture lacerations. 50% risk of pulp death
Extrusion Significant damage to +++. Bleeding: Gum
Replace tooth in socket at 5 years.
supporting structures margin +++.
and splint 2 weeks.
and likely damage to
NV supply.
 Injury Description Findings Management Prognosis
Normally severe
anterior transverse
Painful: +. Wobbly:
impact, but can occur
normally immobile.
with forceful pull of
Bleeding: ++. Tooth Clean. LA normally
something the patient
often not too painful or required to replace
is biting. Tooth root 50% risk of pulp death
Lateral Luxation sensitive as there is tooth and bone
displaces with apex at 5 years.
loss of pulp fragment. Splintage for
lodging into labial
neurovascular supply. 4 weeks.
alveolar bone fragment
Sensitivity is a good
fracture. Tooth
sign here.
becomes abnormally
angulated in socket.
Uncommon. Severe Painful: +. Wobby: Gradual orthodontic or
Difficult. Do not
longitudinal impact. impacted so not surgical repositioning
attempt manual
Tooth rammed into wobbly. Bleeding: +. may be required. Pulp
Intrusion repositioning. Clean
alveolar bone. ‘Shorter’ tooth; Likely death virtually
tooth. Suture gum
Normally associated to be ‘insensitive’ due guaranteed (but tooth
lacerations.
with small fractures. to loss of NV supply. may be retained)
Bleeding: +++ (clot).
Severe See below and the
Consider fractures of
oblique/transverse slides for detail. Time Pulp death is certain so
the alveolar bone and
Avulsion impact. Complete loss out of physiologic root canal treatment at
damage to the other
of the tooth. Relatively media (dry time) is 1 week. Approx.
teeth. Examine the
common. key.
other teeth carefully.
PROGNOSIS

 TERBUKANYA AKAR/APEKS GIGI

 INTAK JARINGAN GINGGIVA
 ADA/TIDAKNYA FRAKTUR AKAR
 DUKUNGAN JARINGAN
PERIODONTAL
INTRUSI EKSTRUSI

PROGNOSIS BAIK
PENATALAKSANAAN ?
 REPOSISI  DILEMBALIKAN KE
POSISI NORMAL SEBISA MUNGKIN

 FIKSASI  DIPERTAHANKAN
SAMPAI PROSES PENYEMBUHAN
BERAKHIR
 REPOSISI

FIXATION

DEBRIDEMENT AND
HECTING
 FIKSASI

WIRE (ESSIG/STOUT
TECHNIQUE WIRE+KOMPOSIT
FIKSASI

ARCH BAR + WIRE

FIBER FIXATION