Travma Geçirmiş Hastada Tüm Ağız Tedavisi: Olgu Sunumu

Year 2013, Volume: 2 Issue: 1, 51 - 54, 01.04.2013

Nilüfer Tülin Polat Mustafa Hayati Atala Fuat Ahmetoğlu Serkan Polat

Abstract

Bu olguda, ağır bir kaza sonrası dental tedavisi gecikmiş ve yoğun girişimsel tedavilerden kaçınan bir hastanın, daha basit tedavilerle tümağız restorasyonu amaçlanmıştır. Alınan anamnezde, hastanın 16 yaşındayken balkondan düştüğü, mandibula da dahil bir çok kemiğininkırıldığı öğrenildi. Çeşitli nedenlerle mandibula kırığı dışındaki, diş ve çevre doku tedavileri 4 yıl ertelenmiş olan hastanın, 11, 13, 14, 15,16, 25,26, 43, 45 nolu dişlerinin kaybedilmiş olduğu görüldü. 17, 18, 24, 33, 34, 35 ve 42 nolu dişlerde değişik boyutlarda kron kırıklarvardı. 23, 44 ve 46 nolu dişlerinin kökleri kemik içinde gömülü kalmıştı. Kapanışta sağda alt ve üst dişsiz kretler birbirlerine, solda ise altyan grup dişler üst dişsiz krete değiyordu. İstirahat ve oklüzal vertikal boyutları arasında 1 mm fark vardı. Hastanın görünümünden dolayıpsikolojisi bozulmuş, yoğun girişimsel tedavilere istek ve tahammülü yoktu. Bu nedenle, ağır travmatik tedavilerden kaçınıldı. Bunun içinalt anterior bölgedeki kemik desteği kaybedilmiş 31, 32 ve 41 nolu dişler çekildi. Sağ üst ve alt, sol üst kretlerden kemik kaldırıldı. 23, 44ve 46 nolu dişlerin kökleri açığa çıkarıldı. Bu köklere ve 24, 36 ve 47 nolu dişlere kanal tedavisi yapıldı. Sağ tarafta sinüs yükseltme ve 3adet implant yerleştirilmesi sonrası alt üst metal destekli seramik restorasyonlarla tedavi tamamlandı. Karmaşık bir vakada, çok azgirişimsel uygulamayla hasta memnun edildi

Keywords

Dental travma, kron kırığı, kron-kök kırığı

Oral Rehabilitation of a Severe Trauma Patient: Case Report

Abstract

It’s been aimed to do the oral rehabilitation of a patient with a delayed dental treatment after a severe accident, by using limited invasivemethods. It is learned from the anamnesis that the patient had been fallen down from the fourth floor at the age of 16. The patient’s oraland dental treatments, except the broken mandibula, had been postponed 4 years for various reasons. She had lost her teeth numbered 11,25 and 43. Her fourteen teeth had different sized crown fractures and 7 of these were embedded in the alveolar bone and mucosa. In thebite occlusion, upper and lower alveolar ridges were in contact on the right side and lower posterior teeth were in contact with the upperalveolar ridge on the left. There was only 1 mm freeway space. Because of the patient’s depression; she had no demand or tolerance toinvasive treatments. The lower anterior 3 teeth which had lost the alveolar support and 3 embedded roots in the right maxilla had beenextracted. Partial bone adjustments -upper and lower right side and upper left alveolar ridges- had been performed. The roots 23, 44, 45,and 46 had been exposed to the oral cavity. Endodontic treatments were done to these roots and 8 other teeth. On the upper right side, 3implants had been placed after the sinus lifting. The treatment had been completed with the porcelain-fused-to-metal restorations.Thepatient had been satisfied by minimum invasive treatment in a complicated case

Keywords

Dental trauma, crown fracture, crown-root fracture

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