| Abstract | Dentalne traume svakidašnja su pojava, posebice u dječjoj dobi. Avulzija je jedan od oblika dentalnih trauma kod koje je zub istisnut iz svoje alveole. Kad je zub izvan alveole, prijeti mu isušenje što utječe na vitalitet PDL-a i pulpe. Nakon 60 minuta nastupa smrt PDL-a. Za spas avulziranoga zuba, potrebno je što prije zub vratiti u alveolu, a ako to nije moguće napraviti odmah, moramo ga sačuvati u jednom od medija za pohranu avulziranog zuba. Postoje tvornički mediji, neki od njih su Viaspan i DentoSafe, ali ako nam nisu pri ruci, tada nam može poslužiti hladno mlijeko ili slina. Ako zub vratimo u alveolu bez predtretmana nekim od materijala za replantaciju ili ako ga predugo držimo na suhom, tada će se povećati mogućnost nastanka ankiloze i resorpcije korijena zuba. Postoje preparati koji ubrzavaju i poboljšavaju cijeljenje i rast PDL-a, usporavaju nastanak ankiloze i resorpcije te zubu omogućuju normalnu adaptaciju i funkciju. Neki od tih preparata su Emdogain, kalcitonin, alendronat, kortikosteroidi, tetraciklini i fluoridi. Oni se nanose na površinu korijena i u alveolu (kalcitonin i ALN mogu i u korjenski kanal). Nakon primjene jednoga od navedenih preparata, zub se vraća u alveolu i imobilizira semi-rigidnim splintom. Za semi-rigidni splint koristi se materijal za privremene mostove ili neki drugi alternativni poput Kevlara, Ribbond vlakna, ortodontskih bravica. Splint se drži od 1 do 6 tjedana nakon čega se odstranjuje. Ako postoji indikacija za endodonciju, tada se ona učini prije skidanja splinta. Očekivano je da replantirani zubi prežive preko 10 godina. |
| Abstract (english) | Dental traumas are everyday phenomena, particularly with children. Avulsion is a form of dental trauma when a tooth is knocked out of its alveolus. When the tooth is out of its alveolus, it is threatened to dry out, which affects PDL and pulp
vitality. After 60 minutes, PDL death occurs. To rescue the avulsed tooth, it is necessary to return the tooth into the alveolus as soon as possible, and if it is not possible to do it immediately, we must preserve it in one of the media for the storage
of the avulsed tooth. There are some factory-made media, some of them are Viaspan and DentoSafe, but if they are not at hand, we can use cold milk or saliva. If we return the tooth into the alveolus without a pre-treatment with some of the materials for the replantation, or if we keep it in a dry place for too long, the possibility of the development of ankylosis and root resorption of the tooth will increase. There are preparations that accelerate and improve the healing and growth of PDL, slow down the development of ankylosis and resorption, and enable the tooth to adapt and function normally. Some of these preparations are Emdogain, calcitonin, alendronat, corticosteroids, tetracyclines and fluoride. They are applied to the root surface and into the alveolus. After applying one of the mentioned preparations, the tooth is returned to the alveolus and is immobilized with a semi-rigid splint. For a semi-rigid splint the material for temporary bridges is used, or some other alternative such as Kevlar, Ribbond fibers or orthodontic brackets. The splint is held for a period of 1 to 6 weeks after which it is removed. If there is an indication of endodontics, then it is done before the removal of the splint. It is expected that replanted teeth survive for more than 10 years. |
