How to remove splinting from the jaw. Jaw fracture treatment. How much does it cost to treat a broken jaw

The main task of the dentist-surgeon during the treatment of a fracture of the upper or lower jaw is to restore the anatomical structure of the broken bone and the correct ratio of the dentition. Many techniques help to achieve this, however, the effectiveness of treatment also depends on how correctly and quickly the first aid was provided.

Before hospitalization

First aid to the victim includes:

• stopping bleeding (pressing or tamponing the wound, applying cold);
• if necessary, cardiopulmonary resuscitation;
• anesthesia (analgin, revalgin intramuscularly);
• immobilization of the jaw with the help of fixing bandages (contraindicated if the victim is unconscious, since this increases the risk of suffocation from the retraction of the tongue or the ingestion of vomit into the respiratory tract).

Treatment methods

1. Operational, or the method of osteosynthesis, consists in fastening the fragments of the jaw with special, often metal, structures.
2. Conservative, or orthopedic - involves the use of special splints that fix the fracture site.

Osteosynthesis

Indispensable for complex, comminuted and multiple fractures with displacement, loose teeth and complete absence of teeth, with periodontal disease and other inflammatory diseases of the gums in the area of \u200b\u200binjury. Osteosynthesis is also effective for fractures of the condylar process complicated by dislocation of the articular head of the lower jaw.

Fastening materials can be steel spokes and rods, pins, nitride-tinan wire with shape memory, fast-hardening plastics, polyamide thread, special glue.

However, osteosynthesis with metal miniplates is considered the most convenient and safe method today. They allow you to dissect the skin and muscles from only one side, which simplifies the operation itself and shortens the recovery time. Another indisputable advantage of these is the ability to reliably fix fragments in areas with significant dynamic loads.

Jaw splinting

This is the immobilization (fixation) of bone fragments using a special plastic or wire construction.

The technique, created by military doctors at the beginning of the 20th century, is successfully used by dentists today. The tire manufacturing materials have changed, and the tire application methods have been improved.

Today, a specialist has many types of tires in his arsenal:

• from Vasiliev's standard tape tires, the simplest and cheapest method of treatment;
• to aluminum tires Tigershdedt, which are made for each patient individually, due to which they are more effective. In addition, they evenly distribute the load and cause minimal injury to the teeth.

The type of splinting depends on the type of injury and can be unilateral (with a fracture of one jaw) or bilateral (when both are damaged).

If the teeth are preserved, it is not difficult to apply a bent tooth splint. It is bent according to the shape of the dental arch and fixed with bronze-aluminum wire ligatures, which, like a hairpin, cover the tooth on both sides. Manipulations are performed under local anesthesia.

In case of fracture of both jaws, a structure with a more rigid base is installed, in addition to wire, hooks and rings are also used, which immobilize the lower jaw.

Is it possible to do without splinting?

Even if the case is not severe - the fracture is one-sided, closed and without displacement, it is imperative to take measures to exclude the development of such unpleasant complications as:

• accidental displacement of fragments,
• repeated injury
• the development of soft tissue inflammation,
• infection of the fracture site.

For this it is necessary to immobilize the jaw by any available method. It can be a sling-like bandage, but it is much more convenient and effective to use a splint. With a complicated fracture, splinting is indispensable, regardless of the location of the injury.

What will happen to the tooth at the site of injury?

If it is mobile, fragmented, dislocated or prevents the jaw fragments from being set, it will have to be removed. The same fate awaits a tooth in the presence of periodontal disease, cysts, granulomas and other inflammations. In other cases, the teeth can be preserved, but they require careful observation.

Displacement fracture management

In such cases, before the splint is applied, it is necessary to match the fragments of the jaw, for which reduction orthopedic devices are used. A broken upper jaw requires traction with special dental splints.

Such injuries are very dangerous in that they can cause asphyxiation. But correctly provided first aid will prevent suffocation. Clean the oral cavity from foreign bodies or blood, lay the victim face down, placing a roller rolled from clothes, blankets, etc. on the chest.

Rehabilitation after a jaw fracture

For the successful treatment of a jaw fracture, anti-inflammatory and restorative therapy, physiotherapy, mechanotherapy and special oral hygiene are also important.

1. Within 3-4 days after injury, to prevent inflammation, antibiotics must be prescribed, which are injected directly into the area of \u200b\u200bdamage.
2. General strengthening therapy is the intake of vitamins C, P, D and group B, drugs that stimulate tissue regeneration and restore the level of leukocytes in the blood.
3. Among the effective physiotherapy procedures, we note UHF therapy, general UFO, magnetotherapy. After the third procedure, the swelling and soreness are noticeably reduced, the swelling subsides. For better passion of fragments, 2 weeks after the fracture of the jaw, electrophoresis is performed using a two to five percent solution of calcium chloride.
4. Mechanotherapy, or physiotherapy exercises, accelerates the restoration of jaw function, helps if, after an injury, the mouth does not open well or does not open at all. It can be practiced at home, starting from 4-5 weeks after the fracture, when the splints are removed and the callus is formed.
5. Special hygiene involves irrigation at least 8-10 times a day. Unconscious victims are treated with a special solution at least twice a day.

How do I eat?

Since during intensive therapy and during the recovery period the jaws are rigidly fixed and habitual chewing of food is out of the question, during this period a correction of the diet is necessary.

Food should be the consistency of low-fat sour cream. These are broths, mashed soups, carefully chopped vegetables and fruits, milk drinks, liquid cereals. Spices are excluded, salt is limited. The temperature of the dish should be no higher than 45-50 ° С. It is most convenient to take food through a straw.

The transition to the usual diet after removing the tire should be gradually. This is important not only for the restoration of chewing functions, but also for the prevention of disorders in the digestive tract.

When are splints removed and how long does the jaw heal?

The older the patient and the more difficult the fracture, the longer it will take for rehabilitation. It is approximately 45 to 60 days. Removal of splints is carried out on the 30-45 day, if the treatment did not include osteosynthesis, and on the 5-14 after it.

How much does it cost to treat a broken jaw?

The price depends on the nature of the injury, on whether osteosynthesis was performed, which splints were used, whether the patient attended physiotherapy procedures. But let's say for sure that the service is not cheap. Osteosynthesis alone will cost from 14,000 to 55,000 rubles.

It is also necessary to consider the cost of subsequent dental treatment for the restoration of lost teeth or damaged after splinting. Our service will help you choose a competent specialist and not waste your money. Compare prices and services of different clinics, read the reviews of real patients.

Fracture of the jaw bones is often accompanied by their displacement. Jaw splinting is designed to fix the bone in a motionless position for the purpose of correct and fast fusion. Immobilization of damaged bones sometimes takes up to one and a half months. This method of treatment involves adherence to certain rules of nutrition and oral hygiene. Since the splinting procedure is an important step in eliminating the displacement of the jaw bones, each patient should know how the fixation structures are applied and removed, and how long the recovery period takes.

Types of splinting for jaw fractures

The method of splinting depends on the nature of the fracture and the severity of the patient's condition:

1. One-sided. It is used in cases where the integrity of the bones of one of the halves of the upper or lower jaw is broken. In this case, the main condition is the presence of healthy teeth in the damaged area, which will serve as a support for the fixing structure. If such units are absent, or they had to be removed, they resort to drilling a hole in the bone to thread copper wire through it.
2. Bilateral. This type of immobilization consists in fixing one of the jaws on both sides using thick wire and rings or hooks installed on the molars.
3. Two-jaw. It is used for complex injuries, when a bilateral fracture is associated with the formation of multiple bone fragments and their displacement. In this case, the splint is used to close the jaws. Splinting in case of a fracture of the lower jaw is performed on the surviving units using rubber rods to maintain the dentition in a closed position.

The choice of materials used for splinting depends on the severity of the injury and the individual characteristics of the patient. The most popular types are metal wires, hooks or rings, plastic structures, fiberglass tapes, and retention bands.

Splint procedure

If during the fracture there was a displacement and the formation of many bone fragments, osteosynthesis is prescribed - surgical immobilization of the fragments with the help of special fixators. The following can be used as fastening structures:

• plates;
• staples;
• screw elements;
• titanium wires;
• polyamide threads;
• curable polymers.

Most often, during osteosynthesis, metal plates are used for fixation. The splint is applied under local anesthesia. The patient should be prepared for the fact that for the entire period of immobilization he will lose the ability to open his mouth. For uncomplicated jaw fractures, Vasiliev's tape splint is used - the cheapest method of treatment.

In case of a complex fracture of the jaw, splinting (shunting) is performed using a Tigerstedt bimaxillary splint. This design is made according to individual parameters. The arch is applied to the teeth with retainers upwards on the upper jaw and downwards on the lower jaw.

Temporary fastening of the metal to the bone is carried out using a thinner wire, which is wound between the lateral sides of the tooth with stretching and twisting near its neck. During double-jaw splinting, rubber bands must be used to give stability to the structure. If the rubber rod has burst, the tire must be reinstalled.

A splint on the jaw requires a special approach to nutrition. Since chewing function is impaired after a fracture, throughout the entire period of immobilization, the diet should include only liquid food. It is recommended to grind it with a blender. It is best to consume grated food and drinks through a straw. If it is impossible to insert a straw into the mouth, a special catheter is used, with the help of which food enters the body through the gap behind the wisdom tooth.

To prevent weight loss, the calorie content of meals should be 3000-4000 calories per day. To this end, it is recommended to include rich meat broths, high-calorie cocktails and kefir with a high percentage of fat in the menu. 150 g of pureed meat is the required daily minimum of protein. All food should be warm - about 40-45 degrees. When preparing dishes, it is not recommended to salt them too much and add a lot of spices - if possible, they should be completely abandoned.

The use of alcoholic beverages is strictly prohibited. They are capable of provoking vomiting, as a result of which the patient can choke on his own vomit. To accelerate the recovery of bone sutures, the daily diet should include meals with the necessary amount of calcium, phosphorus and zinc. It is also recommended to use fruit, vegetable and berry juices, compotes and fruit drinks without pulp.

After removing the fixing structure, you should gradually switch to solid food. This will allow you to restore chewing function in stages, avoiding digestive problems and preparing the stomach for normal nutrition.

Since there is a high probability of infection after a fracture of the jaw, associated with a rupture of soft tissues, special care is required for the oral cavity. You should brush your teeth at least 2 times a day (for more details, see the article: when exactly should you brush your teeth - before or after meals?). In this case, you need to regularly clean out the remnants of food from the interdental spaces using dental floss, a special brush or a toothpick (we recommend reading: how to use a toothbrush correctly to clean your teeth?).

It is necessary to rinse your mouth after every meal. If it is difficult to clean your teeth from plaque with a toothbrush, you need to purchase an irrigator.

How long does the jaw heal and when are the splints removed?

No specialist will be able to accurately answer the question of how long it will take for the complete fusion of damaged bones. This period depends on the severity of the damage to the jaw and the quality of treatment, as well as on the individual characteristics of the patient.

In most cases, full recovery takes 1-1.5 months. For complicated injuries, rehabilitation can take from 6 to 12 months. The speed of recovery largely depends on the patient's compliance with all the doctor's recommendations.

A special set of exercises for developing muscles and joints, as well as various physiotherapy procedures, helps to speed up the healing of bone fragments. Physiotherapy is prescribed after the splints have been removed after the minimum period for the fractured bones to heal. Regular visits to the attending physician to monitor the correct fusion of damaged bones will significantly speed up the recovery process and prevent possible complications.

Tire removal process

Before removing the fixing structures, the doctor necessarily takes a control X-ray. If the fracture line is overlapped by a pronounced callus, then there is no point in further use of the splint. It is removed by carefully bending all the fastening elements, using special dental instruments.

This process is not difficult and does not take much time. Upon completion of all manipulations, the specialist issues a referral to the patient for physiotherapy and teaches the technique of performing developing gymnastics.

Often during the use of splints due to the impossibility of full cleaning of the teeth, diseases of the teeth and gums develop. At the end of the jaw immobilization stage, it is imperative to visit the dentist to examine the oral cavity and eliminate dental problems if they are detected.

Splinting cost

The cost of the splinting procedure depends on a number of factors: the region of service provision, the price policy of the medical institution, the method of immobilization and the materials used. Also, the degree of damage affects the cost of installing a tire.

The price for osteosynthesis is from 14 to 55 thousand rubles, splinting using fiberglass or aramid thread will cost about 3 thousand rubles. for 1 tooth. In addition, you will have to pay for the services of a doctor to monitor the quality of therapy, physiotherapy courses and dental treatment, which may be needed in case of the development of diseases of the teeth or gums while wearing the fixing structure.

Fractures of the upper and lower jaw are often accompanied by displacement of the fragments. For their reposition (comparison) in dental practice, jaw splinting is used. This method fixes the broken bone and immobilizes it for 3 to 6 weeks.

Features of the procedure

Important! The splint is attached to the intact teeth that fit tightly in the holes. But since most of them have to be removed, the surgeon makes holes in the bone for fixation.

Since displaced injuries are often open and accompanied by rupture of the mucous membrane, it is conventionally believed that they occur with the penetration of microbes into the tissues. Therefore, antibiotic therapy is always prescribed. Additionally, tetanus injections are indicated.

Types of splinting

The method of treatment is selected based on the type of fracture. There are several types of splinting:

Important! X-ray diagnostics are performed before the procedure. It is necessary to determine the nature of the injury, the number of fragments and the direction of their displacement.

Rehabilitation period

After installing the splint, a difficult rehabilitation period begins. It lasts from 3 weeks to a month and a half. All this time, it is necessary to carefully observe oral hygiene.

Important! The first few days after installing the splint, the teeth can be very disturbing: there are aching, bursting pains.

The main difficulty arises with nutrition. Pureed food is introduced through a tube. But with two-jaw splinting, this method is not always feasible. You have to feed food through a catheter. It is placed on the lower jaw in the gap behind the extreme teeth - "eights".

Certain requirements are imposed on the diet during rehabilitation:

It is noted that during the period of rehabilitation, patients significantly lose weight. However, after the splints are removed, patients quickly return to shape. The tires are removed only after a control X-ray. The image should clearly show the callus overlying the fracture line.

However, the recovery doesn't end there. For 2 to 3 weeks, the patient should be fed the same way as with splints. To restore the functionality of the jaw, physiotherapeutic procedures and therapeutic exercises are prescribed.

Today it is the most effective way to restore a damaged dentition. There are also special external devices to avoid joining two jaws. However, they are bulky, highly inconvenient, fragile, difficult to hygiene and unaesthetic.

Injuries associated with damage to the jaw bones can lead to dangerous consequences for a person, so you should be aware of the symptoms and treatment of a jaw fracture, as well as how much does it clamp?

Pathology occurs due to a pronounced mechanical effect on the jaw, or due to other pathologies. Distinguish between partial damage to the bones, complete, with displacement and others. Self-medication in cases of such injuries.

Causes of a jaw fracture

The main causes are divided into two types: pathological and traumatic.

Pathological, including anomalies of the anatomy of the jaw bones and the consequences of diseases of various etiologies:

• hereditary pathologies;
• malignant and benign neoplasms;
• osteomyelitis;
• cysts;
• tuberculosis;
• treatment with certain drugs;
• metabolic disorder;
• lack of nutrition, vitamins and minerals;
• infections and others.

Traumatic, including the consequences of falls, injuries, blows, injuries, intense loads, road accidents and other conditions. More often injuries are caused by:

• driving various types of transport;
• active lifestyle and other incidents;
• abnormal removal of one or more teeth;
• under severe physical impact, for example, when using a firearm, injuries to the jaw can be complicated by the appearance of fragments.

Kinds

The bones of the lower jaw are lined up in the shape of a horseshoe, it is easily crushed. The most common localization of fractures is the area of \u200b\u200bthe coronoid process, incisors, canines, angles.

In the upper jaw, the weakest in the structure of the place is the closure with other bones. In minor injuries, as a rule, displacement occurs without the formation of fragments. With injuries received in the area of \u200b\u200bthe upper jaw frontally, there is a risk of displacement of the fragment down and back. In the event of falls, indirect impacts, there is also a risk of the formation of fragments and their displacement to the base of the skull.

Classification of fractures according to the severity of the lesion:

1. Open, in which bone fragments are displaced towards soft tissues, tearing or damaging them (mucous membranes, muscle, skin). More often, open fractures of the lower jaw are observed, less often of the upper jaw. With this type, the risk of bacterial damage to damaged tissues is high, medical assistance is provided immediately.
2. Closed, in which the bone is damaged, but soft and nearby tissues are not affected. Closed types of fracture are more often localized in the region of the branches of the lower jaw, its angle. They are easier to treat than open ones.

Classification based on the displacement of debris

1. A displaced fracture occurs when a traumatic force is severely applied. The jaw bones move in relation to each other and to other bones. In this case, the displacement can be both sagittal and vegetative, transversal.
2. Non-displacement fracture, in which the bone is damaged or divided into fragments, but they are not displaced, are related to each other anatomically. Most often these are incomplete fractures.
3. Sometimes this classification includes the type "with a concussion."
4. Splintered, flowing with the formation of several bone fragments of different sizes at once, randomly located. They are characteristic for a powerful traumatic effect on the jaw. They only require hospital treatment, self-medication is not permissible.
5. Full, in which the fragments or fragments (fragments) of the damaged bone are displaced, have a transverse, oblique slope.

Complete fracture degrees:

1. Single;
2. Double;
3. Multiple;
4. Comminuted.

Types of jaw bone injuries according to Lefort:

1. Lefort - I. The boundaries of the injury run along the base of the nose, then along the upper wall of the orbit and zygomatic arches. Otherwise, it is called subbasal. The patient's medical history includes complaints of visual doubling of objects, pain when swallowing. This fracture is characterized by edema, characteristic eye symptoms.
2. Lefort - II. The boundaries of the fracture are located at the base of the nose, the lower wall of the orbit, then along the zygomatic-maxillary junction. Suborbital type. With it, some parts of the face become numb, tears stand out, bleeding from the nasopharynx is characteristic.
3. Lefort - III. The boundaries of the fracture run along the base of the pear-shaped opening, the bottom of the maxillary sinus. Lower type. The patient will complain of pain, difficulty in chewing, bleeding, difficulty in bite.

By location, fractures are divided into:

1. The middle one is in the area of \u200b\u200bthe central incisors.
2. Incisor - between the lateral and first incisors.
3. Canine - on the canine line.
4. Mental - in the area of \u200b\u200bthe chin opening.
5. Angular - in the area of \u200b\u200bthe angle of the lower jaw.

In relation to the place of impact, fractures are divided into direct (directly in the area of \u200b\u200binjury), indirect (in the opposite place).

First aid

Medical assistance on the spot, pending qualified, should be provided as soon as possible. The basic rules are:

• to provide complete rest to the patient in a motionless state;
• restore breathing (cardiopulmonary resuscitation as needed);
• suggest analgesics;
• remove all excess from the oral cavity;
• disinfect the wound;
• stop the bleeding;
• with minimal knowledge, try to align the bones.

Jaw fracture - treatment

Any kind of injury, both the upper and lower jaw, is treated in a surgical hospital. In complicated cases, surgery is indicated.

Upon admission, the patient is anesthetized, a bandage is applied, diagnostics are performed (X-ray, CT, MRI), bone structures are restored with sutures, staples, plates. Implants are installed if it is not possible to put together the patient's bones. Treatment includes antibiotic therapy, physiotherapy. The main methods of treatment are splinting and shunting.

Splinting

The bone fragments are adjusted using a special plastic device. In case of a fracture on one side of the face, the device will be applied on the same side, in case of a complicated one - on two with the addition of special rings and hooks.

In case of injury to both jaws, complicated by the displacement of fragments, splints are applied to both jaws (double-jaw technique). The main goal of the method is to ensure the immobility of the healing tissues. Treatment can take up to 2 months. Before the splints are removed, the patient is x-rayed to make sure that the tissues are fused.

Bypass surgery

The method is used in complicated cases. In this case, the injured bone fragments are fixed with special tires, consisting of hook loops and rubber intermaxillary rods (Tigerstedt's bus).

The method allows, in addition to fixation, to reduce the load on the patient's bones.

Nutrition

Even with a simple fracture, the patient has nutritional difficulties. Depending on the severity of the injury, the patient is selected a method of nutrition with auxiliary measures.

1. Drinking cups with tubes are used in the absence of a part of the teeth. It is injected directly into the stomach. Food should be moderately warm, served in small portions, fractional. The method is suitable for home use.
2. Probes are used strictly in hospitals in the first weeks. The tube is inserted into the stomach.
3. Dropper for parenteral food intake if the victim is unconscious.
4. Enemas for nutrition are used in case of unconsciousness and with difficulty feeding the patient through the veins.

What can you eat with damage to the jaw:

• high-calorie meat dishes, diluted with milk or pureed broth;
• baby food;
• dairy and fermented milk liquid drinks;
• broths;
• mashed soups;
• fruit, vegetable purees and soufflés;
• porridge diluted with milk.

Important: the diet should compensate for the patient's daily calorie requirement.

Video: how to eat properly with a fractured jaw? Personal experience of a video blogger. You can also find other tips on his channel.

Effects

As a rule, jaw fractures do not go away without unpleasant consequences. Injuries can result in:

• asymmetry and deformation of facial features;
• loss of teeth and their movement, while the teeth are loose when chewing and at rest;
• violation of the bite;
• gaps between the teeth;
• psychological discomfort of the patient when the jaw crunches.

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THE NEED FOR SHINING. INDICATIONS

Tooth splinting or bypass grafting is the connection of several loose teeth into one group using special orthopedic devices. This procedure immobilizes and further strengthens the teeth united in the block, preventing their curve growth and loss.

Before and after photos:

Splinting performed in the early stages of the disease can completely stop the mobility of the teeth over time. In advanced cases, it will only help to temporarily fix the position of the teeth - until the next stage of treatment.

Signals for teeth splinting:
violation of the dentition, displacement of the teeth;
loose teeth due to trauma;
periodontitis and other gum diseases;
severe bleeding of the gums;
rapid accumulation of dental plaque near the root;
pronounced gingival pockets and the formation of pus in them;
exposed dental roots.

SPINING AS DENTAL SALVATION IN PERIODONTITIS

With periodontitis, the gums bleed, the periodontal tissues (periodontium) are destroyed, and purulent discharge appears. Dental mobility is the main symptom of the disease in the middle and severe stages of development. The reason for the loosening of the teeth is bone atrophy of more than 25% of the length of the tooth root. The more the bone is atrophied, the higher the degree of tooth mobility.

Visually determine atrophy by the bare necks of the front teeth. The decrease in bone is clearly visible on the radiograph. It is considered normal when the bone tissue reaches the level of the tooth neck.
Lack of treatment threatens to increase symptoms, including dental mobility. Under the influence of the chewing load, weakened teeth are deformed, or rather, they bend in different directions.

Saving loose and fragile teeth - dentistry. When you notice a problem, it is important to see a doctor immediately. Splinting teeth with periodontitis will allow you to keep in place the teeth that have just begun to loosen. If dental intervention is delayed, some teeth may not be saved. In addition, if at least 1 tooth falls out, then those next to them will lose their balance and begin to loosen and move faster. In such a situation, to perform splinting, you will first need to replace the lost tooth (or teeth) with an implant. It is not hard to guess that the cost of such treatment will be much more expensive and will last longer.

TEETH SPLINING METHODS

The principle of the procedure is the application of a durable splint to the inner surface of the teeth. The dentist defines movable teeth in one group. In the same group, there should be 2 stable teeth for a reliable fixation of the splint. there is several ways of splintingin which such materials and structures are used:
fiberglass thread;
aramid thread;
copper wire (to restore the dentition after jaw injuries);
crowns;
prostheses.
Distinguish temporary splinting and permanent... Temporary splints are worn from 2-3 weeks to several months. Temporary splinting is prescribed in combination with serious surgical procedures in the treatment of periodontal diseases.

Permanent splinting is used to start the process of immobilizing teeth for a long time. Permanent splints are divided into removable (prostheses) and non-removable (threads, tapes, wires; composite substances).
Let's take a closer look at each method.

Teeth splinting with fiberglass

The technique differs depending on the location of the problem teeth. The splinting of the lower front teeth is carried out as follows:

1. The doctor cuts out a horizontal groove on the inner surface of the teeth, the length of which is about 2 mm.
2. The resulting area is flooded with light composites.
3. One piece fiberglass thread is placed.
4. Polymerization.

For splinting the front upper teeth, the same method is used, but with one change: the cut followed by the installation of the splint is made from the outside of the teeth.

The splinting of the chewing teeth is also done according to this principle, but the groove is cut out on natural crowns.

The fiberglass splint stabilizes the teeth. When chewing, the load is distributed evenly. If later it becomes necessary to remove the splint, the thread is removed and the furrow is filled.

Benefits:
splinting teeth with periodontitis with fiberglass inhibits the process of atrophy of bone tissue, thereby giving a chance to preserve all mobile teeth;
there is no need to remove the pulp;
teeth and gums are not injured during the procedure;
after splinting, there is no discomfort in home oral care.

Cable-stayed splinting of teeth

This method is similar to splinting teeth with fiberglass. Only the material of the tire is different. For the cable-stayed method, a braided aramid fiber tape is used.
Installation of aramid splint is carried out in the same way as splinting teeth with fiberglass floss: cutting a horizontal groove, placing the floss, sealing.
As a result of the dental work done in the patient, the shade of the teeth is normalized, the dentition is restored, the pressure during chewing is distributed equally, the interdental gaps are closed.

List of benefits:
enamel compatibility;
does not enter into a chemical reaction with food, saliva;
aramid is a strong, durable material;
does not interfere with the usual hygiene procedures in the oral cavity;
sometimes - an alternative to prosthetics.

Splinting teeth with crowns

When more than 4 teeth are loosened, splinting the teeth with fiberglass tape is not recommended, as the result will be short-lived. With a large number of loose teeth, splinting with crowns will be more durable.

The procedure for the dentist:
1. Filling of root canals.
2. Grinding teeth.
3. Installation of crowns welded to each other.

Benefits:
efficiency;
long service life.

For upper and lower teeth that are open for review, dentists suggest installing crowns made of all-ceramic or metal-ceramic. Metal crowns are often put on the distant teeth, which significantly reduces the cost of the service for patients.

Clasp splinting

A removable splinting clasp prosthesis is used in the absence of one or more teeth. The design is a metal arch with clasps that clasp and fix each tooth. In addition, the clasp has artificial teeth that replace the missing natural ones. The chewing load moves from the dentition to the plate. The teeth are gradually strengthened and restored.

Benefits:
replacement of lost teeth;
keeping teeth from grinding;
service life up to 7 years.

The clasp is made like this:
diagnostics of periodontal diseases;
making casts of jaws;
making a model of the oral apparatus;
calculation of structural details;
wireframe creation;
trying on a prosthesis;
final fit.

OTHER CIRCUMSTANCES

Splinting teeth after braces

After braces are removed, the teeth are at risk of returning to their naturally crooked position. To maintain mobile teeth in good condition, dental bypass surgery is used.

Any method of splinting teeth is acceptable. The decision is made by the orthodontist after consultation with the patient.

With a fracture

Teeth after dislocation and fracture of the jaw bones must be saved with a splint. Before the procedure, a panoramic X-ray of the damaged area is taken, the teeth in the fracture area are removed. The next step is to collect the jaw fragments and fix them. The method of splinting depends on the severity of the injury.

Types of teeth splinting:
1. Unilateral splinting: fracture of one half of the upper or lower jaw. Copper wire is used for shunting. It is attached with dental splinting to the injured area. In the event that there are teeth left at the site of injury, the splint is combined into one system and placed on the neck of the teeth.
2. Double-sided. A splint is applied on both sides of the jaw. Fixation of teeth with wire is provided, but it must be stiffer than with one-sided teeth splinting technique.
3. Bilateral: bilateral displacement fracture. If there are still teeth left, a copper wire is attached to them for the base. The splinting of movable teeth is done differently: the splint is inserted into the holes drilled by the dentist in the alveolar bone. Then 2 jaws are interlocked with rubber rings, which are fixed with hooks.

Teeth ache after splint installation

Some people complain of pain in the first days and weeks after splinting. This is due to the fact that the jaw gets used to the introduction of a foreign body into it. If your teeth hurt after a dental session and do not stop, make an urgent appointment with a dentist.

HOW MUCH DOES SPINING COST

Depending on the chosen method and the number of teeth to be treated, the price will differ. Splinting the front teeth with fiberglass thread costs 7,000 rubles on average. Cable-stayed teeth splinting will cost more. The price for coronal splinting of 1 tooth starts from 3500 rubles (made of metal). If the choice fell on a ceramic crown for splinting 1 tooth, then it will cost from 12,000 rubles. You can buy and install a clasp design for 25,000 rubles or more.

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1. Orthopedic dental structure

The indications for the connection of the teeth are neglected conditions of the soft tissues that hold the tooth during periodontitis. There is a marked loosening, leading to the mobility of the chewing elements. To prevent further deterioration, mobile teeth are splinted.

May be:

The procedure eliminates the risk of loss of chewing units due to poor gum health and retaining structures.

The service offered by dentistry, dental splinting, significantly helps to correct deformities in the location of mineral formations caused by periodontitis diseases. Indications for connecting part of the chewing row are: bleeding of the gums, severe exposure of the crown, atrophy of the retaining part of the bone, changes in the ligamentous apparatus.

2. What is splinting of mobile teeth

We will understand the need for a dental bypass procedure, what is this photo manipulation below and what it is done for, and in its implementation.

This is the overlay method:

• threads (aramid, fiberglass, quartz);
• wire (copper) after damage, injury;
• crowns, plates or dentures.

The method combines several chewing elements using fixation.

Gentle technology of applying threads on the inner side of mineral formations, with their combination

It is often performed on the front and front parts of the upper or lower chewing row. It is also installed on molars and in the partial absence of teeth on the ground remaining crowns.

When teeth are splinted, the price can be different, depending on the material used to restore the disorders. Combining them into one group with different designs and the number of units affects the formation, with the method of splinting mobile teeth, prices. It will be different depending on the used orthopedic systems and the group of mineral formations to be immobilized.

3. Fixing floss system, price for teeth splinting in dentistry

High quality filament ribbons

If tightening is carried out with a thread, seals made of durable photopolymer are installed on top. Access to the surface for treatment and hygiene is retained. It looks aesthetically pleasing. Doesn't cause discomfort. The thread is thin and very strong. How much it costs to splinter the front teeth will, again, depend on the tape chosen. The most commonly used cable-stayed method, with durable fiberglass.

Held:

• from the inside on the front teeth;
• and on the chewing side, on the lateral solid units.

Teeth splinting with fiberglass prices

The initial cost starts from 1500 rubles. It can go up to 3000 rubles. The procedure for fixing the material depends on the complexity of the preliminary preparation of the chewing elements, the volume of cutting the groove and the number of units combined into a group.

4. Bypass surgery what is it if no threads are used

Teeth splinting photos before and after prices

The application of ligature splints or the installation of one-piece prostheses is less gentle than the introduction of a dense tape inside the groove on the surface of the mineral formation. Consider what is the splinting of mobile teeth, the price of the procedure, if not a thread, but other designs are used.

Although the tape is more convenient for fixing the loosened chewing row, there are indications for its connection with other orthopedic structures.

Permanent metal-ceramic structure for connecting the side group of chewing elements, photo after its installation

Prosthetic teeth splinting what is it

This is the use of metal-ceramic bridges or clasp prostheses, which gives a longer service life. But it can only be installed on pulp channels.

Clasp system

Having figured out how teeth splinting is carried out, what is this price should be taken into account as well. It will be roughly the cost of the number of units worn.

Calculation for crowns for splinting movable teeth price: the cost of one design (as for a conventional crown), multiplied by the sum of the fixed units and plus the work on dental treatment.

Clasp prostheses - 25,000 rubles.

Take into account what will be the price with this method of fixation, such as bypass surgery, the price must be preliminary. The choice is based on the individual characteristics of the patient.

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Symptoms of a fracture of the upper or lower jaw with a photo

Such an injury is accompanied by the following symptoms:

Classification of fractures of the upper jaw

Injuries to the upper jaw are classified by the level of the fracture and by its nature. In the latter version, fractures with displaced fragments and without displacement are distinguished. By level (place) they are:

• Fracture Le Fort I - at the lower level. In case of a bilateral fracture, it is accompanied by a breaking off of the bottom of the maxillary sinus and a broken base of the nasal septum.
• Le Fort II fracture - at the average level. Often accompanied by separation of the upper jaw and nasal bones from the skull.
• Fracture Le Fort III - at the upper level. It is accompanied by complete separation of the upper jaw, nasal bones and cheekbones from the skull, as well as traumatic brain injury.

Also, injuries are distinguished by their nature:

• traumatic - as a result of external influences;
• pathological - as a consequence of diseases (tuberculosis, osteomyelitis, syphilis, etc.).

There may be complete and incomplete fractures:

• when full, the injured bone is interrupted;
• incomplete - expressed by cracks, breaks.

Fractures can be open or closed. Injuries to the upper jaw are rarely closed, because there is a rupture of the mucous membrane of the oral cavity. Fractures are also classified by the number of injuries: single, double, multiple.

Types of fractures of the lower jaw

Fractures of the lower jaw are complete and incomplete, open and closed, single, double and multiple. The clinical picture shows that most often injuries occur in the area of \u200b\u200bthe corners (angular fracture), articular and condylar processes. The fracture of the mandible is represented by the following classification:

• by the type of fracture: linear, finely splintered, coarsely splintered, with and without displacement;
• depending on the consequences: tooth loss, incisor in the moon;
• at the site of the injury: the branch, the base of the condylar process, trauma in the area of \u200b\u200bthe coronal process was injured;
• in the direction of impact: oblique, zigzag, transverse and longitudinal.

First aid

In case of a fracture, the following steps should be taken before a doctor is examined:

After all these measures, you must immediately consult a doctor. Having a damaged jaw is very dangerous and can cause serious complications. The best and safest option would be to call an ambulance. Usually, people with such injuries are placed in the maxillofacial department.

Diagnostic methods

To establish the presence of a fracture without obvious signs and understand what to do next, the doctor will be helped by the patient's complaints and symptoms, but the following methods should be used to make an accurate diagnosis and determine the complexity of the fracture:

• initial examination and palpation;
• x-ray;
• cT scan;
• orthopantomography;
• masticiography;
• gnathodynamometry;
• myography;
• thermovisiography;
• rheography;

X-ray diagnostics is a mandatory procedure that reliably shows the presence of a fracture, its complexity, pathology, whether there are fragments and problems with the roots of the teeth. X-ray does not require any additional preparation. However, it should be abandoned by pregnant women, patients with bleeding and people in serious condition.

Usually, several images are taken in frontal, lateral and axial projections:

• In frontal projection, the image usually shows the general condition of the jaw. It is done lying on the stomach on the front side.
• Lateral x-rays are used as an addition to the former. On it you can see large defects and the condition of the teeth. The patient is placed on the desired side and a cassette is applied to the cheek.
• Axial projection shows through bilateral fractures of the lower jaw, as well as defects in trauma to the articular and condylar processes of the lower jaw. The patient is placed on his stomach and the chin is pulled.

Examination and palpation

During the examination, swelling of the face at the site of the fracture is immediately visible. If the skin in the area of \u200b\u200bedema has a red or pink color, then complications have appeared in the form of an inflammatory infiltrate. Blue skin color indicates bleeding in the subcutaneous tissues. Fractures can be accompanied by blue discoloration of the neck, chest, and abdomen.

On examination, an asymmetry of the face also signals an injury. Hemorrhage in the eyes may indicate a fracture of the base of the skull. This is also indicated by the secretion of cerebrospinal fluid (cerebrospinal fluid) from the nose. It is often confused with normal bleeding, but it is more dangerous and can lead to inflammation of the brain and a significant weakening of the body. How badly a person is affected depends on their anatomy.

Only at the end of the examination, the doctor starts palpation. It is imperative that the sensitivity of the skin of the nose and lips is checked to find out if the infraorbital nerve is damaged. When there is a suspicion of a fracture of the lower jaw (condylar process), its base and the posterior edge of the branch are palpated. These are the narrowest parts of it. If it is impossible to probe at least one head, we can talk about trauma to the condylar and articular process. To determine the location of the upper jaw injury, the doctor presses on the wisdom teeth or the last molars.

Treatment methods

Fractures can only be treated in a hospital. Braces and plates are used to restore bone. Antibiotics and physiotherapy are prescribed. In the most severe cases, surgery is possible (for example, with a fracture of the articular process of the lower jaw). The main treatment is by splinting and bypassing, or in other words, splint.

Different types of splinting

Splinting is the most commonly used treatment method. In this case, the broken place is fixed with a special structure made of plastic or wire. A plastic retainer is used when emergency assistance is needed to the victim and for his transportation (for example, in case of a fracture of the condylar process of the lower jaw). Additionally, a bandage is applied. The type of wire splint depends on how much the broken jaw has suffered:

In some cases, fixation can be done with a bandage. Before splinting the jaw, the bone fragments must be carefully aligned. The splint is usually put on for 1 month.

Tigerstedt splint overlay

Serious injuries are treated with a special Tigerstedt splint. It is an aluminum construction with hook loops and rubber intermaxillary traction. If the rubber band has burst, then it is necessary to reinstall the tire. Self-removal of the applied splint is strictly prohibited.

What can you eat during treatment?

During bone healing, certain nutritional difficulties arise. The patient cannot chew as before, so the food must be liquid and at the same time fully cover the need for vitamins and minerals.

• infant formula and cereals;
• puree from vegetables and fruits;
• broths, mashed soups;
• milk, kefir, fermented baked milk, yoghurts;
• porridge with milk;
• grated meat, diluted in milk or broth.

After removing the splint, start eating solid food gradually. This will not only allow to gradually develop the chewing function, but also prepare the stomach for normal nutrition, prevent disturbances in its work.

How long does it take for a fracture to heal?

On the 28-30th day after the X-ray of the broken jaw, if everything is normal, the splint is removed. However, you shouldn't rejoice ahead of time. A course of rehabilitation and restoration of all functions is still ahead.

Rehabilitation and the consequences of a fracture

With injuries to the jaw, the following complications and consequences can occur:

• Osteonecrosis is the death of a fractured bone, especially with injury to the condylar process of the lower jaw. With its possible development, an operation is indicated.
• Violation of chewing functions - after a long inactivity, the jaws are difficult to open and close. Mechanotherapy helps speedy rehabilitation.
• Change in bite due to improper fusion of fragments. As a result, pain may occur when the jaw moves. This is due to early removal of the splint and poor immobilization.

Also, asymmetry of the head and changes in facial features may appear, loss of teeth in the future, the appearance of cracks between the teeth. Psychological discomfort is caused by the crunch of the fused jaw. In order to avoid all these consequences, you should consult doctors in time for timely and qualified treatment.

As a rehabilitation, they recommend physical therapy, enhanced oral hygiene, physiotherapy (massage, electrophoresis, etc.). The active phase of rehabilitation begins a month after everything heals. You can learn more about first aid for a fractured jaw and the process of applying a splint in the video.

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Before splinting

Immediately after the fracture of the jaw bones and a visit to the doctor is done panoramic shot, showing the severity of the fracture and helping to plan treatment.

After that, all teeth are removed from the fracture area, since it will no longer be possible to return them to functionality. After removal, the fragments of the jaw are collected together and fixed with sutures and other instruments and devices, and only then a splint is applied to the jaw to provide rest to the fused bones.

Types of jaw splinting

Injuries to the jaw bone tissue can be with or without displacement. For splinting both the upper and lower jaw, different splints are used, depending on how severe the fracture is. There are several splinting methods that differ in the way they are fixed.

Unilateral splinting

This type of splinting is used if only the one half of the upper or lower jaw... In this case, a copper wire is used as a tire, which is attached to the jaw by the method of tooth splitting. If the teeth were saved at the fracture site, then the splint is placed on the neck of the teeth, combined with the tooth in one system.

Double-sided splinting

In this case, the splint is fixed on the jaw with two sides... The wire for bilateral splinting is used more rigid, and to make the fixation even more reliable, hooks and rings are put on the molars.

Double jaw splinting

This type of splinting is necessary if the patient is diagnosed with a bilateral fracture with displacement of debris. It is used only in the most severe cases, when displacement can severely impair the functionality of the jaw.

If the patient still has immobile teeth, then a copper wire is placed on them. If only loose teeth remain, then the splint is placed in the alveolar bone, for which holes are specially drilled in it. The splints are placed on both jaws, after which they connected with rubber ringswith hooks.

If the jaws are rigidly fastened together, then the person will not be able to open his mouth himself, so the healing process of cracks and fractures will significantly accelerate, and the correct bite will recover faster. Sometimes, for additional fixation of the lower jaw, a special chin slingfirmly pressing the chin up.

How is the treatment going

A splint is only the very beginning of a long-term treatment. If the splint is single-jawed, then this is not so scary, but if it is installed on both jaws, then it will not even be possible to open your mouth, so you have to eat only liquid food... And after the tire is removed, the jaw will take a long time develop.

In order for the installed devices to give the maximum effect and the treatment went as it should, you must carefully follow all the recommendations of the dentist and monitor your diet.

Today there are modern devices with which even two jaws can be splinted without combining them with each other. True, usually such devices are very bulky, fragile, uncomfortable, interfere with washing and generally look awful. Therefore, most often people prefer to endure the inconvenience of the jaws connected to each other.

IMPORTANT: You can supplement the diet during splinting with protein shakes for athletes and baby formula and puree.

Proper nutrition after splinting

• Eat through a tube, and the food you eat must be mushy
• It will be useful to include kefirs and various high-calorie cocktails in your diet.
• When wearing a two-jaw splint, categorically it is forbidden to use any alcoholic beverages... The reason is that alcohol can provoke vomiting, which the patient will simply choke on, since he cannot open his mouth.
• In order for the bone sutures to heal as quickly as possible, you need to eat as many foods as possible with calcium... Various fermented milk products are especially useful, as well as sesame seeds and walnuts, which can be finely ground
• To replenish protein in the body, you need to eat at least a day 150 grams of pure meatthat in the bus can be somewhat problematic. It is recommended to boil a turkey or chicken in water with spices and salt, then grind dry meat in a blender and dilute with broth
• Fruit mixes, porridge mousses, vegetable purees and other dishes are also prepared in the above way.
• You can supplement the diet while splinting protein shakes for athletes and infant formula and puree

It is worth remembering that after splinting, you are likely to seriously lose weight, even if your diet is complete. This is due to the fact that the digestibility of food is difficult. However, usually after removing the tires with a normal power supply weight is restored very quickly, but there are no problems with digestion.

Recovery period

With such a diagnosis as a fractured jaw, tissues can regenerate for a long time. Splints are usually removed after the minimum period of bone healing has passed. Usually the splint needs to be worn from three weeks to one and a half months, depending on how complex the fracture is.

Before removing the splint, the patient is given a control X-ray of the damaged area. If the fracture line is overlapped by a pronounced callus, then the splint can definitely be removed. After that, rehabilitation lasts two to three weeks, during which you will still need to eat grated soft food, as well as visit physiotherapy to return the jaw to mobility.

Despite all the inconveniences associated with splinting, this method is still the most effective and efficient way to restore the functionality of the jaw and is widely used in maxillofacial surgery.

IMPORTANT: Despite all the inconveniences associated with splinting, this method is still the most effective and efficient way to restore the functionality of the jaw and is widely used in maxillofacial surgery. What is Skye? The appearance of teeth in children

With a face injury, the integrity of the bones of the facial skull is violated. If the traumatic blow exceeds the safety margin of the jaw body, the jaw is fractured. Reasons: falling from a height, injuries in road accidents, household, sports.

Signs of a fracture: deformation of the cheekbone, change in bite, inability to close teeth. If the surrounding tissues are intact, the fracture is closed. The tissues of the face and oral mucosa are damaged - an open fracture.

Incomplete fracture if parts of the jaw have not moved. A complete fracture is diagnosed when the fragments are displaced; comminuted fracture is rare.

Fracture symptoms

Certain symptoms indicate trauma to the facial bones. They are visible visually or felt by the victim:

1. Hemorrhage and swelling of the damaged area, which gives asymmetry to the facial features.
2. Pain on palpation, aggravated by movements of the mouth.
3. Violation of bite.
4. Displacement of the chipped parts of the jaw.

Depending on the location of the fault, injuries are:

• in the center of the incisors - middle;
• in the canine area - canine;
• between the first incisor and lateral - incisal;
• on the chin - mental;
• behind the 8th tooth - angular;
• the upper third is a branch fracture;
• the basis of the condylar process;
• in the area of \u200b\u200bthe condylar process - cervical;
• in the area of \u200b\u200bthe coronoid process - coronary.

First aid

Correct first aid for such an injury guarantees the success of further treatment. If the victim is conscious and breathing is not disturbed, it is necessary to fix the jaw with a bandage. Flatten and bandage across the bottom of the chin and crown. Use the tools at hand: put plywood under the upper teeth, immobilize the jaws with a handkerchief or scarf.

If a person is in an unconscious state, you must first make sure that he can breathe. Empty mouth if necessary and prevent tongue swallowing (sit down or lay on side).

Use sterile material to plug or compress the wound to stop or reduce bleeding. Apply cold to the injured surface and give an anesthetic to relieve shock, pain. The best option is an intramuscular injection, if not, then analgesics (promedol, nalbuphine, fentanyl). Try to keep the victim conscious. Get to the hospital as soon as possible.

Treatment and splinting for a fracture of the lower jaw

When diagnosed, after examination, an x-ray is taken. Doctors check whether the spine is injured, whether there is a concussion, or intracranial bleeding.

The main treatment for injury is splinting. The jaw is fixed by applying a splint until complete fusion. This usually lasts 1-1.5 months. Doctors produce:

• Treatment and disinfection of the received wounds;
• Comparison, fastening of fragments using titanium plates and screws;
• The imposition of a splint to immobilize the jaw;
• Anti-inflammatory therapy.

Select the type of splinting.

Teeth splinting in case of jaw fracture

First you need to take a panoramic shot in order to choose a fixation method. Splinting is performed with special structures (removable or non-removable) for fixing and correct fusion of fragments. Wire or plastic construction is used to fix damaged areas:

• Unilateral fracture - the wire splint is installed on one side;
• In case of multiple fractures, a 2-sided structure with a rigid base is installed using hooks and rings;
• If both jaws are broken and a displacement has occurred, a 2-jaw splint is placed, attached to the teeth with copper wire. The jaws are secured with rubber rings attached to the hooks;
• A plastic splint is applied under the chin and wrapped over the crown to secure it. Used when transporting a patient to traumatology.

Teeth splinting in case of a fracture of the lower jaw

Determine the degree of damage using an X-ray of the jaw. In the area of \u200b\u200bthe fracture, the teeth are removed. The broken bone fragments are held together with special clamps. A splint is applied.

According to the indications, choose the type of splinting: one-sided or two-sided. Splinting is necessary if the debris is displaced. This is the only way for the complete immobilization of the parts and their correct fusion.

Osteosynthesis (the operation of connecting fragments into a whole) is carried out to firmly fix the fragments in the correct position using various devices. They use wire, screws, pins, knitting needles, plates from materials that are not subject to corrosion. If conservative methods do not provide the necessary immobilization of jaw fragments, osteosynthesis is used. This method is used if:

• there are no stable teeth on the fragments;
• fragments are saline displaced;
• the fracture with displacement passed behind the teeth;
• comminuted fracture;
• it is necessary to carry out reconstructive surgery and osteoplasty.

The operation is performed under general anesthesia, as it is necessary to cut the soft tissues to insert the fixing plates and fixators.

The methods of osteosynthesis are used:

1. The fragments are held together with a bone suture. Material - nylon thread, stainless steel wire, titanium.
2. Connecting fragments using mini-bone plates fixed with screws.
3. The use of fast-hardening plastics to immobilize fragments.
4. Applying osteoplast glue.
5. Nickel-titanium brackets. The shape of the staples is selected in accordance with the nature and location of the fracture.
6. Kirchner spokes.
7. Combined methods - for reliability and strength of fastening.

There are many other ways, techniques and techniques. It is necessary to select the most appropriate for a particular case with the help of doctors - professionals in this field.

Splints on teeth in case of fracture

Splinting teeth in case of fracture is one of the methods of immobilization. Tape standard or individual (made for a specific patient) splints are used. Special intermaxillary elastic rods ensure the correct position of the fragments.

This makes it difficult to eat and take care of the teeth and oral mucosa, but gives a good treatment result. After removing the splint, you must go through a rehabilitation period. Physical procedures and jaw gymnastics are prescribed. The patient should be persistent and make efforts to strengthen the muscles and restore their functions.

Nutrition for splinting teeth

With a fixed state of the jaw, the patient can be fed only in liquid (broths, soups) and semi-liquid (wiped) form. At the same time, it is necessary to provide high-calorie food: soups based on meat and fish broths, cereals, vegetables, dairy products. Eat vegetable fats when cooking.

After removing the splint, you cannot immediately eat solid food, but introduce it into the diet gradually. Correctly undergo a rehabilitation course. Therapeutic exercises are needed to develop the chewing muscles.

It is important to properly maintain the patient's medical record, because rehabilitation can be carried out in different clinics. In addition, this documentation is necessary to establish the severity of the injuries received, for the registration of sick leave, insurance documents.

During treatment, oral hygiene should be carried out by the attending physician and the patient. You need to clean your teeth and splint after eating, irrigate the mucous membrane with antimicrobial solutions, rinse with chamomile, soda solutions, use an antiseptic.

With proper first aid and qualified treatment, compliance with all doctor's prescriptions, the prognosis of injury is favorable. Over time, the muscles strengthen, the functions of chewing and speech are restored.