J Korean Assoc Oral Maxillofac Surg.  2010 Aug;36(4):309-313. 10.5125/jkaoms.2010.36.4.309.

The conservative care by early endodontic drainage of infected teeth in the line of a mandibular fracture: report of a case

• Mo DY
• Yoo JH
• Choi BH
• Sul SH
• Kim HR
• Lee CU

• KMID: 1457784
• DOI: http://doi.org/10.5125/jkaoms.2010.36.4.309

Abstract

The management of teeth in the line of a mandibular fracture is controversial despite the general agreement that most of these teeth can be preserved. Teeth should be retained if bony attachments are adequate for survival, the tooth is sound and important in maintaining fixation of the fractured segment of bone. Teeth should be removed if they are loose and interfere with the reduction of fragments, are devitalized and potentially a source of wound infection, are damaged beyond their usefulness or may become devital and interfere with healing by becoming infected. However, tooth removal will increase the level of trauma, extend the severity of the wound and require expensive prosthetic treatment. Therefore, it is very important to conserve infected teeth in the line of a mandibular fracture through early primary endodontic treatment (pulp extirpation, canal enlargement and canal opening drainage) and splinting. The basic principles underlying the treatment of pulpless teeth are those underlying general surgery. Therefore, debridement of the infected wound (pulp extirpation and canal enlargement), drainage (canal opening) and gentle treatment of the tissues (occlusal reduction and teeth splinting) are the principles of surgery. This is a representative case report of conservative care by the early endodontic drainage of infected teeth in the line of a mandibular fracture.

Keyword

Teeth in line of a mandibular fracture; Early endodontic treatment; Conservative teeth care

MeSH Terms

Debridement
Drainage
Mandibular Fractures
Tooth
Tooth, Nonvital
Wound Infection

Figure

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  Fig. 1. Initial view of the infected tooth #42 in the line of a mandibular symphysis fracture.

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  Fig. 2. Initial dental panoramic view.

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  Fig. 3. Primary wiring and endodontic drainage view of #42 and labial incision and drainage view for the prevention of infection of a mandibular symphysis fracture.

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  Fig. 4. Lingual incision and drainage (sutured rubber strip) view for the prevention of infection of a mandibular symphysis fracture.

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  Fig. 5. Closed reduction view of arch bar application and intermaxillary fixation in a mandibular fracture

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  Fig. 6. Maintenance view of the sutured lingual rubber strip drain.

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  Fig. 7. Follow-up check of dental panoramic view in 3 weeks.

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  Fig. 8. Endodontic treatment view on #42 tooth.

Reference

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