Department of Dental Clinics, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, CE, Brazil.
Dent Traumatol. 2009 Oct;25(5):510-4. doi: 10.1111/j.1600-9657.2009.00789.x. Epub 2009 Jul 9.
Intrusion is defined as the axial dislodgment of the tooth into its socket and is considered one of the most severe types of dental trauma. This longitudinal outcome study was undertaken to evaluate clinically and radiographically severely intruded permanent incisors in a population of children and adolescents. All cases were treated between September 2003 and February 2008 in a dental trauma service. Clinical and radiographic data were collected from 12 patients (eight males and four females) that represented 15 permanent maxillary incisors. Mean age at the time of injury was 8 years and 9 months (range 7-14 years and 8 months). Mean time elapsed to follow-up was 26.6 months (range 10-51 months). The analysis of data showed that tooth intrusion was twice as frequent in males. The maxillary central incisors were the most commonly intruded teeth (93.3%), and falling at home was the main etiologic factor (60%). More than half of the cases (53.3%) were multiple intrusions, 73.3% of the intruded teeth had incomplete root formation and 66.6% of the teeth suffered other injuries concomitant to intrusion. Immediate surgical repositioning was the treatment of choice in 66.7% of the cases, while watchful waiting for the tooth to return to its pre-injury position was adopted in 33.3% of the cases. The teeth that suffered additional injuries to the intrusive luxation presented a fivefold increased relative risk of developing pulp necrosis. The immature teeth had six times more chances of presenting pulp canal obliteration that the mature teeth and a lower risk of developing root resorption. The most frequent post-injury complications were pulp necrosis (73.3%), marginal bone loss (60%), inflammatory root resorption (40%), pulp canal obliteration (26.7%) and replacement root resorption (20%). From the results of this study, it was not possible to determine whether the type immediate treatment had any influence on the appearance of sequelae like pulp necrosis and root resorption after intrusive luxation, but the existence of additional injuries and the stage of root development influenced the clinical case outcome in a negative and positive manner, respectively.
嵌入是指牙齿轴向移位到牙槽窝中，被认为是最严重的牙齿创伤类型之一。本纵向研究旨在评估儿童和青少年中严重嵌入的恒牙的临床和放射学表现。所有病例均于 2003 年 9 月至 2008 年 2 月在牙科创伤服务中治疗。从 12 名患者（8 名男性和 4 名女性）中收集了 15 颗恒上门牙的临床和放射学数据。受伤时的平均年龄为 8 岁 9 个月（范围为 7-14 岁 8 个月）。平均随访时间为 26.6 个月（范围为 10-51 个月）。数据分析显示，男性牙齿嵌入的发生率是女性的两倍。上颌中切牙是最常嵌入的牙齿（93.3%），跌倒在家是主要的病因（60%）。超过一半的病例（53.3%）为多发性嵌入，73.3%的嵌入牙齿根形成不完全，66.6%的牙齿伴有嵌入性脱位的其他损伤。66.7%的病例选择立即手术复位，33.3%的病例选择观察等待牙齿回到受伤前的位置。伴有嵌入性脱位的附加损伤的牙齿发生牙髓坏死的相对风险增加 5 倍。未成熟的牙齿发生牙髓管闭塞的可能性是成熟牙齿的 6 倍，发生牙根吸收的风险较低。受伤后最常见的并发症是牙髓坏死（73.3%）、边缘骨丧失（60%）、炎症性牙根吸收（40%）、牙髓管闭塞（26.7%）和替换性牙根吸收（20%）。从本研究的结果来看，无法确定即刻治疗类型是否对嵌入性脱位后牙髓坏死和牙根吸收等后遗症的出现有影响，但附加损伤的存在和根发育阶段分别以负面和正面的方式影响临床病例结果。
