Cehreli Zafer C, Sara Sezgi, Aksoy Burak
Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
J Mich Dent Assoc. 2013 Mar;95(3):58-62.
Pulp necrosis is an uncommon sequel to extrusive luxation in immature teeth with incomplete apical closure. In this report, we describe the management of severely extruded immature maxillary incisors and the outcome of revascularization to treat subsequent pulp necrosis. An 8.5-year-old boy with severe dentoalveolar trauma to the anterior maxillary region as a result of a fall was provided emergency treatment consisting of reduction of the dislodged labial cortical bone and repositioning of the central incisors, which had suffered extrusive luxation. When he presented with spontaneous pain involving the traumatized incisors a week later, the teeth were treated via a revascularization protocol using sodium hypochlorite irrigation followed by 3 weeks of intracanal calcium hydroxide, then a coronal seal of mineral trioxide aggregate and resin composite. Complete periradicular healing was observed after 3 months, followed by progressive thickening of the root walls and apical closure. Follow-up observations confirmed the efficacy of the regenerative treatment as a viable alternative to conventional apexification in endodontically involved, traumatized immature teeth.
牙髓坏死是根尖孔未完全闭合的年轻恒牙受到脱出性脱位后的一种罕见后遗症。在本报告中，我们描述了严重脱出的年轻上颌切牙的治疗方法以及采用牙髓血管再生术治疗随后发生的牙髓坏死的结果。一名8.5岁男孩因跌倒导致上颌前部区域严重牙牙槽创伤，接受了紧急治疗，包括复位脱位的唇侧皮质骨并重新定位遭受脱出性脱位的中切牙。一周后，当他出现受伤切牙的自发疼痛时，通过牙髓血管再生术进行治疗，先用次氯酸钠冲洗，然后根管内放置氢氧化钙3周，再用三氧化矿物凝聚体和树脂复合体进行冠部封闭。3个月后观察到根尖周完全愈合，随后根壁逐渐增厚，根尖孔闭合。随访观察证实，对于牙髓受累的创伤性年轻恒牙，再生治疗作为传统根尖诱导成形术的一种可行替代方法是有效的。
