Traumatismes et complications pulpaires : prévention et attitude thérapeutique

Dental trauma and pulpal implications: prevention and therapeutic approaches

Adresse de correspondance : E. MANDEL, 63, avenue Franklin D-Roosevelt, 75008 Paris.

Résumé

La plupart des traumatismes dentaires interviennent avant ou pendant un traitement orthodontique avec une regrettable concomitance. Les atteintes pulpaires sont alors fréquentes même en l’absence de signes cliniques évocateurs tels qu’une fracture coronaire. La prise en charge de la dent traumatisée comporte le diagnostic de l’état pulpaire, le diagnostic de l’état parodontal, la restauration des pertes de substance coronaire voire coronoradiculaire. L’attitude orthodontique en regard de ces dents est détaillée en fonction de chaque type de traumatisme.

Abstract

The dental pulp is frequently affected by injuries to teeth, even in the absence of overt signs of trauma such as a coronal fracture. Clinical and radiographic examination should not be limited to teeth that appear to be directly damaged by the impact. Neighbouring, opposing, and even distant teeth may have been traumatized by the blow, often indirectly, and should be assessed. Treatment of involved teeth begins with a diagnosis of the condition of the pulp as well as the periodontium followed by restoration of lost coronal, and, possibly, root structure. Finally, an orthodontic treatment approach to dealing with these teeth based on the individual nature of the traumatic event must be formulated.