July 18, 2020
Our teeth are held steadily in so called alveolar sockets within the jawone. These sockets surround the roots of the teeth and a minor portion of the crown to have a steady grasp on the teeth. But what guarantees the firmness of these sockets? The human teeth have a distinct organ known as the periodontium. It comprises of the gingiva, cementum, alveolar bone and the periodontal ligament. In this article we will talk about the fracture of the alveolar bone, the same tissue system that houses the dental sockets.
It is important to understand that supporting the teeth is not the only important function of the alveolar bone. Moreover, even while giving support to the teeth, the alveolar bone takes help from the adjacent tissues in the process. To begin with, the shape and formation of the alveolar bone is entirely dependent on the development of the teeth. If a tooth is exfoliated or extracted, the alveolar bone will also diminish with time. The alveolar bone has two chief components: a cortical bone and a compact bone. Cortical is derived from the word cortex, which means a hard covering. The cortical bone covers not only the bulk of the tooth but also has perforation through which various blood vessels pass through. Compact, as the name suggests, hints at something that is spongy in nature. This part of the alveolar bone bears the forces on the teeth that are exerted due to chewing. They adapt themselves in a way that the stress on the teeth are evenly distributed. Now that we have established the importance of this organ, let us see how expensive it's fracture can be.
Alveolar bone is also known as alveolar process
The alveolar bone, which is also known as the alveolar process, forms the bulk of both the maxilla and the mandible. This might give an indication as to how severely complicated a scenario may arise, if this bone fractures. The fracture of the alveolar bone can be seen in any region of the oral cavity even though it is more common in the front region. It may or may not involve the involvement of the corresponding teeth. It can be a painful condition and might have unwanted effects on appropriate closing of the jaws.
The fracture lines that develop in an alveolar fracture might travel a significant length of the jaw bones and can involve more than two teeth at times. These fracture lines can be more clearly seen on a full mouth radiograph, known as an orthopantomogram. In more severe cases the floor of the maxillary sinus may also get involved, thereby further complicating the condition. An alveolar fracture will usually require more than one radiograph, each of which is taken at different angles.
The segment that is involved in the fracture might cause a shift in the position of the tooth or the teeth in that region. This leads to abnormal closing of the jaw, dysfunction in the muscles involved in chewing and pain in the temporomandibular joint. Moreover, if the displacement of the segment is an intense one, the gums might develop lacerations. It is often seen that in alveolar fractures the blood supply to the involved teeth is compromised. The root of the teeth may also gets chewed away by the various chemicals that are released following the inflammation due to the fracture.
Treatment of fractured alveolar bone
Treatment of the alveolar bone fracture consists of repositioning the displaced segment. This repositioning can be done almost like solving a jigsaw puzzle. Once the segment finds its fit, the dental surgeon will stabilize it through some wiring techniques. Following this, depending on the extent of the fracture, the area is immobilized for a significant time period. In the process, the teeth are also splinted together. The immobilization period maybe as short as 4 weeks and as long as 5 years. Gingival lacerations may be sutured if needed. Teeth that have lost their vitality might need an endodontic therapy which involves cleaning and disinfecting of the root canal followed by its complete restoration.
Alveolar fractures might be even more complicated in children. Apart from it being a painful condition for the children, the fractured segment might also affect the tooth bud of the permanent successor and hinder its development. In such a case, the fractured segment is repositioned under general anaesthesia. Moreover, the permanent tooth bud which is in the line of fracture needs to be evaluated at regular time intervals by the dentist through means of radiograph until the tooth erupts.
Alveolar fractures affect the entire morphology of the face. It is a condition that needs an expert dental surgeon who can not only reposition the bone but also assure a flowing symmetry of the face, the smile and the functionality of the oral cavity.