Faus-Matoses Vicente, Martínez-Viñarta María, Alegre-Domingo Teresa, Faus-Matoses Ignacio, Faus-Llácer Vicente J
DDS, MSc. Master of Restorative Dentristy and Endodontics, Department of Stomatology, Medicine and Dental School, Valencia University, Spain.
DDS, MSc. Master in Prosthetic Dentistry, Department of Stomatology, Medicine and Dental School, Valencia University, Spain.
J Clin Exp Dent. 2014 Oct 1;6(4):e425-9. doi: 10.4317/jced.51374. eCollection 2014 Oct.
Intrusive luxation is a type of recognizable luxation injury represented by a deeper axial displacement of the tooth toward the alveolar bone. Treatment strategies include waiting for the tooth to return to its position, immediate surgical repositioning, and repositioning through dental traction by orthodontic devices. The aim of this case report was to present the management of severe dental trauma and later restoration following IADT. A 20-year-old patient was presented after fainting at home four hours before, resulting in a dento-alveolar trauma. Clinical examinations revealed a traumatic intrusion, in 1.2, 1.1 and 2.1, uncomplicated crown fractures in 1.1 and 2.1 and a complicated crown-root fracture in 2.2. The diagnosis was confirmed with CBCT. Following IADT protocol, the emergency treatment consisted of the surgical repositioning and semi-rigid splinting using orthodontic wire-composite, replacing the buccal bone plate, and postoperative instructions to the patient regarding oral hygiene. After 2 weeks the root canal treated and filled with fiberglass posts in 1.2, 1.1, 2.1 and 2.2. Splint was removed after 4 weeks and the IADT reassessment protocol followed, with revisions at 6-8 weeks, 6 months, a year and annual reviews for 5 years. A year after the treatment, the traumatized teeth were restored with minimally invasive preparations of feldspathic ceramic. Esthetics and function were recorded with a 3-year follow-up period. Key words:Intrusive luxation, dental trauma, crown-root fracture, dento-alveolar trauma, permanent tooth, CBCT.
嵌入性脱位是一种可识别的脱位损伤类型,表现为牙齿向牙槽骨的轴向深部移位。治疗策略包括等待牙齿自行复位、立即手术复位以及通过正畸装置进行牙齿牵引复位。本病例报告的目的是介绍嵌入性脱位性牙外伤的处理及后期修复。一名20岁患者在4小时前在家中晕倒后就诊,导致牙-牙槽外伤。临床检查发现1.2、1.1和2.1牙为外伤性嵌入,1.1和2.1牙有简单冠折,2.2牙有复杂冠根折。通过CBCT确诊。按照嵌入性脱位性牙外伤治疗方案,急诊治疗包括手术复位、使用正畸钢丝-复合树脂进行半刚性固定、更换颊侧骨板以及向患者说明术后口腔卫生注意事项。两周后对1.2、1.1、2.1和2.2牙进行根管治疗并充填玻璃纤维桩。4周后拆除固定装置并遵循嵌入性脱位性牙外伤再评估方案,在6至8周、6个月、1年时进行复查,并在5年内每年复查。治疗1年后,对患牙采用长石质陶瓷进行微创预备修复。对美观和功能进行了为期3年的随访记录。关键词:嵌入性脱位;牙外伤;冠根折;牙-牙槽外伤;恒牙;CBCT