Liječenje prijeloma zuba i zaostalog korijena zuba

Mirta Vučković
Veterinarski fakultet Sveučilišta u Zagrebu, Heinzelova 55, 10000 Zagreb

Izlaganje sa Međunarodnog znanstvenostručnog skupa

Izvor: Zbornik radova 7. Hrvatski veterinarski kongres, Srebreno, 2024.

Sažetak

Prijelomi zuba su česti problem kod pasa i mačaka, često uzrokovani vanjskim ozljedama ili žvakanjem tvrdih predmeta poput rogovlja, kostiju ili krutih igračaka za žvakanje. Najčešće slomljeni zubi kod ovih životinja su očnjaci te pretkunajci i kutnjaci. Simptomi povezani s prijelomima zuba uključuju žvakanje uglavnom na jednoj strani, ispuštanje hrane tijekom jela, povećano slinjenje, škripanje zubima, čeprkanje po ustima, oticanje lica, uvećane limfne čvorove, izbjegavanje kontakta lica prilikom maženja, nevoljkost za uzimanje tvrde hrane i nezainteresiranost za tvrde poslastice ili igračke. Prema Američkom veterinarskom dentalnom koledžu (AVDC), postoji pet kategorija prijeloma zuba kod pasa: prijelom cakline, jednostavni prijelom krune, složeni prijelom krune, jednostavni prijelom krune-korijena i složeni prijelom krune-korijena. Složeni prijelomi krune predstavljaju najčešći oblik traumatskih dentoalveolarnih ozljeda, koji se obično javljaju na gornjoj čeljusti i pogađaju ključne zube.
Kada se zubna pulpa izloži, važno je hitno liječiti zub, jer ovo stanje uzrokuje bol i može dovesti do infekcije pulpe, što rezultira nekrozom i širenjem infekcije na periapikalna tkiva (endodontska bolest). Ako tip prijeloma to dopušta i vlasnik želi spasiti zub, preporučuje se endodontsko liječenje, koje može uključivati vitalnu ili potpunu pulpektomiju. Vitalna pulpektomija smatra se hitnim postupkom, jer se vjerojatnost uspješnog liječenja smanjuje 48 sati nakon izlaganja pulpe, posebno kod zrelih zuba. Ako vlasnik odabere potpunu pulpektomiju ili vađenje zuba, liječenje se može odgoditi do sljedećeg dostupnog termina; međutim, životinji bi tijekom tog vremena trebala biti osigurana terapija protiv boli. Zaostali korijeni zuba i fragmenti korijena povezani su s visokom učestalošću patologije. S vremenom, zaostali korijen u čeljusti može uzrokovati značajne upalne procese i periapikalne lezije, koje mogu biti izuzetno bolne. Nakon pregleda usne šupljine i rendgenskog snimanja, kirurško uklanjanje zaostalih korijena preporučeni je postupak u oralnoj i maksilofacijalnoj kirurgiji.

Ključne riječi: prijelomi zuba, vađenje, vitalna pulpektomija, endodontsko liječenje, zaostali korijeni.

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TREATMENT OF TOOTH FRACTURES
AND RETAINED TOOTH ROOTS

Mirta Vučković

Tooth fractures are a common issue in dogs and cats, often caused by external injuries or the chewing of hard items such as antlers, bones, or rigid chew toys. The canine (fang) teeth and the large, sharp upper molars and premolars at the back of the mouth are the most frequently fractured teeth in these animals. Symptoms associated with tooth fractures include chewing predominantly on one side, dropping food while eating, increased drooling, teeth grinding, pawing at the mouth, facial swelling, enlarged lymph nodes, avoiding facial contact when petted, reluctance to eat hard food, and disinterest in hard treats or toys. According to the American Veterinary Dental College (AVDC), there are five categories of tooth fractures in dogs: enamel fracture, uncomplicated crown fracture, complicated crown fracture, uncomplicated crown-root fracture, and complicated crown-root fracture. Complicated crown fractures represent the most common form of traumatic dentoalveolar injuries, typically occurring in the maxilla and affecting key teeth. When the dental pulp becomes exposed, it is crucial to treat the tooth promptly, as this condition causes pain and can lead to pulp infection, resulting in necrosis and the spread of infection to the periapical tissues (endodontic disease).
If the fracture allows and the owner wishes to save the tooth, endodontic treatment is recommended, which may involve either vital or complete pulpectomy. Vital pulpectomy is considered an emergency procedure since the likelihood of successful treatment decreases 48 hours after pulp exposure, particularly in mature teeth. If the owner chooses total pulpectomy or tooth extraction, the treatment may be postponed until the next available appointment; however, the animal should receive pain management during this time. Retained tooth roots and root fragments are associated with a high incidence of pathology.
Over time, a retained root in the jaw can cause significant inflammatory processes and periapical lesions, which can be extremely painful. Following an examination of the oral cavity and dental radiography, the surgical removal of retained roots is a recommended procedure in oral and maxillofacial surgery.

Key words: tooth fractures, extraction, vital pulpectomy, root canal treatment, retained roots

Vezano:

Sažetak

TREATMENT OF TOOTH FRACTURES AND RETAINED TOOTH ROOTS

Vezani sadržaji

TREATMENT OF TOOTH FRACTURES
AND RETAINED TOOTH ROOTS