Treatment of patients with fracture of alveolar process

03-09-2009
Treatment of patients with fracture of alveolar process
Under the conduction anesthesia is necessary reponirovat otlomok and install it in the correct position. In this case the fingers is fixed and the health section of the alveolar process in order to make sure we do not further break the mucous membrane and periosteum, which is essential for the outcome of treatment. Immobilization of fragments can be accomplished through a smooth tire-bracket, if the undamaged portion of the alveolar process has a sufficient number of stable teeth (at least 2-3 on each side of the line of fracture). In the case of fracture of the lateral section of the alveolar process in the bus should be at least 4.5 stable teeth with intact side. Sometimes it is rational to impose additional chin sling. If the sides otlomlennogo area of the alveolar process has no teeth (or can not be used for the attachment of tooth wire bus), should produce a fast-hardening plastic zubonadesnevuyu bus. Center it have on the damaged alveolar process, and the side sections to form the basis of prosthesis - on both sides of it. Under the base tire drill through the undamaged portion of the alveolar process to the vestibular side of oral. In formed input channels nylon or wire ligatures, impose on reponirovanny alveolar bone bus and connect the ends of ligatures over her mouth in anticipation of [Shvyrkov MB, 1974]. 

Immobilization of alveolar bone fragments are usually carried out during the 5-7ned. If there was a complete separation of splinters, sharp edges should be smooth bone cutter, and the mucous membrane, mobilizing it to take in the tightly wound over the bone, ie to surgical treatment of bone injuries. If you take in the wound is not possible, it is closed gauze pad soaked in yodoformnoy mixture. First shift tampon produced by 7-8-th day. 

If the fracture line passes through the roots of teeth, fragments of consolidation often does not occur. This is due to poor blood supply of the fragment, since such close proximity to the gum line of the fracture edge, he is sclerotized to a considerable length. In addition, remove the broken root of the fragment broke off without any additional incisions and peeling mucous-periosteal flap is not always possible. This further worsens the microcirculation broken-off section of the alveolar process. Therefore a high probability of traumatic osteomyelitis and subsequent sequestration of it. Having said that, in this clinical situation rationally once a radical surgical treatment, similar to that of the full isolation of broken fragments. 


General therapy of patients with fracture of the alveolar process, including medication, aimed at prevention of complications of inflammatory nature and optimization of reparative osteogenesis, is shown in the relevant section of the monograph.

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