First aid treatments in dental avulsion - literature review

Uvod: Avulzija zob predstavlja eno težjih in pogostejših oblik poškodb zob. Ključno vlogo pri ohranitvi avulziranega zoba predstavljajo pravilni prvi nujni ukrepi, ki jih mora medicinska sestra poznati, saj ima aktivno vlogo pri različnih zdravstvenih dejavnostih, kjer se lahko sreča s tovrstnimi poškodbami. Z ustreznim znanjem medicinska sestra prav tako lahko deluje tudi na zdravstveno-vzgojni ravni. Namen: Namen diplomskega dela je opredeliti pojem avulzije zob in s pomočjo strokovne in znanstvene literature predstaviti prve nujne ukrepe pri tej poškodbi. Za lažje razumevanje diplomske tematike bomo predhodno predstavili tudi osnove zobne anatomije in nomenklature. Metode: Uporabljena je bila deskriptivna metoda dela s pregledom strokovne in znanstvene literature preko podatkovnih baz: COBIB.SI, Wiley online Libery, PubMed in Science Direct. Časovni okvir nastalih člankov je bil od leta 2012 do 2017. Vključenih je bilo 49 del. Rezultati: Avulzija zob pomeni popoln premik zoba iz zobne alveole in se uvršča med dentoalveolarne poškodbe. Takoj po poškodbi se začne odmiranje celic parodentalnih ligamentov, kar posledično vpliva na reimplantacijo in s tem povečuje tveganje izgube zoba. Za uspešno rehabilitacijo avulziranega zoba so ključni prvi nujni ukrepi, med katere uvrstimo čas ukrepanja, pravilno rokovanje, primeren medij za shranjevanje zoba in napotitev poškodovanca skupaj z zobom v zobozdravstveno ustanovo. Razprava in zaključek: Reimplantacija avulziranega zoba se mora izvesti v najkrajšem času na kraju dogodka. Če to zaradi različnih dejavnikov ni mogoče, se zob vstavi v medij za shranjevanje. Pri slednjem še ni določeno, kateri je najbolj idealen. Poleg prvih nujnih ukrepov lahko uvrstimo tudi kontraindikacije le-teh, in sicer v primeru mlečnih zob, pri katerih smernice odsvetujejo reimplantacijo avulziranega mlečnega zoba. S poznavanjem prvih nujnih ukrepov pri avulziji zob lahko preprečimo nepotrebno izgubo zoba ter druge nevšečnosti, ki bi dodatno brez potrebe prizadele pacienta.Introduction: Dental avulsion is one of the most serious and most common dental injuries. Appropriate first-aid treatments are the key to tooth conservation. Nurses should have knowledge of these treatments, since, with their active role in different medical procedures, they easily encounter such injuries. With adequate knowledge they can operate on a health education level. Purpose: The purpose of this thesis is to define dental avulsion and, using scientific and professional literature, to present appropriate first-aid treatments with this type of injury. We will present the basics of dental anatomy and nomenclature for easier understanding. Methods: We have used the descriptive methods with the overview of the professional and scientific literature using databases: COBIB.SI, Wiley online Library, PubMed and Science Direct. The publishing period of the reviewed articles was between the years 2012-2017. There were 49 works included. Results: Dental avulsion is the complete displacement of a tooth from is alveolus and it is included among dentoalveolar injuries. As soon as the injury occurs, the necrosis of the periodontal ligament cells begins, and this, accordingly, has significant impact on dental reimplantation and it increases the risk of the tooth loss. First-aid treatments are essential for successful rehabilitation of dental avulsion, where the main role include time, proper handling, proper storage medium, and the referral of the injured, together with the tooth, to dental practice. Discussion and conclusion: Reimplantation of the avulsed tooth must be performed in the shortest time at the place of the event, and, if that is not possible due to various factors, the tooth must be placed in proper storage medium. It is still not clear which storage medium is ideal. Besides first-aid treatments, we can include contraindications namely in the case of primary teeth, where guidelines advice against the reimplantation. With knowledge of the first-aid treatments with dental avulsion, we can prevent unnecessary tooth loss and other inconveniences, which would additionally unnecessarily impact the injured