Sardana D, Goyal A, Gauba K
Unit of Pedodontics and Preventive Dentistry Oral Health Sciences Center Post-graduate Institute of Medical Education and Research, Chandigarh, India.
Unit of Pedodontics and Preventive Dentistry Oral Health Sciences Center Post-graduate Institute of Medical Education and Research, Chandigarh, India.
Singapore Dent J. 2014 Dec;35:71-6. doi: 10.1016/j.sdj.2014.04.001.
Avulsion is one of the most serious injuries of the tooth which is most commonly seen in young children and occurs in the upper front teeth. Immediate transplantation of the avulsed tooth is recommended treatment and results in good prognosis although this may not be always possible.
The present case highlights the 3-year follow-up of delayed replantation (after 15h) of maxillary central incisor which was avulsed due to trauma. The complications seen in the present case were ankylosis and inflammatory resorption, but clinically the tooth was asymptomatic and maintains the esthetics of the individual signifying the importance of delayed replantation even after prolonged extra-oral time.
Although complications like ankylosis or root resorption may be unavoidable, delayed replantation of avulsed tooth may be a good alternative to prosthesis (implant or fixed partial denture) till the growth is completed due to preservation of the alveolar bone and psychological benefit to the patient. Also efforts should be made to educate and update children, teachers and parents regarding management of avulsed tooth at accident site and also the dentists regarding its management in dental office.
牙脱位是最严重的牙齿损伤之一，多见于幼儿，且以上前牙最为常见。尽管并非总是可行，但建议对脱位牙进行即刻再植，其预后良好。
本病例重点介绍了因外伤脱位的上颌中切牙延迟再植（15小时后）的3年随访情况。本病例中出现的并发症为牙根粘连和炎性吸收，但临床上该牙无症状，且保持了个体的美观，这表明即使在长时间牙离体后，延迟再植仍具有重要意义。
尽管牙根粘连或吸收等并发症可能不可避免，但对于脱位牙，延迟再植可能是一种很好的替代修复方式（种植或固定局部义齿），因为它可以保留牙槽骨，对患者有心理益处，直至生长发育完成。此外，应努力对儿童、教师和家长进行教育，使其了解在事故现场对脱位牙的处理方法，同时也应对牙医进行教育，使其了解在牙科诊所的处理方法。
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