Rocha Lima Thiago Farias, Nagata Juliana Yuri, de Souza-Filho Francisco José, de Jesus Soares Adriana
Professor Department of Restorative Dentistry, Endodontics Area Federal University of Paraíba, João Pessoa, Paraiba, Brazil Phone: 982226564, e-mail:
Department of Dentistry, Federal University of Sergipe Lagarto, Brazil.
J Contemp Dent Pract. 2015 Jan 1;16(1):13-9. doi: 10.5005/jp-journals-10024-1628.
The aim of this study was to evaluate the main post-traumatic complications of severe luxation and replanted teeth using clinical and radiographic analyses.
Eighty-three patients aged between 7 and 55 years old presenting 180 traumatized teeth that suffered extrusive luxation (n=67), lateral luxation (n=69), intrusive luxation (n=10) and tooth avulsion (n=34) followed by replantation were evaluated. The follow-up period was 24 months. The complications examined were: pulp canal obliteration, pulp necrosis and root resorption (infammatory and replacement). Furthermore, the relationship between time elapsed before receiving dental attendance and development of infammatory resorption was observed.
Pulp necrosis was the main complication, occurring in 147 teeth (82.7%). All of the teeth that suffered intrusive luxation and tooth avulsion were diagnosed with pulp necrosis, with significant difference in comparison with another traumas (p<0.001/Fisher's exact test). Infammatory root resorption was observed in 20.5% of the cases and replacement resorption was more related to tooth replantation (94.1%), showing significant prevalence among tooth luxations (p<0.001/Fisher's exact test). In addition, it was noted that patients who seek treatment 9 weeks after the trauma episode presented 10 times more chance of developing infammatory resorption when compared with patients who seek treatment soon after dental trauma (Odds ratio test).
It may be concluded that pulp necrosis was the main post-traumatic complication observed in traumatized teeth and that delay in seeking treatment may damage the prognosis of severe luxation and replanted teeth.
Clinical studies describing the main complications that may affect traumatized teeth present great relevance to make the population aware of the importance of seeking immediate treatment and to alert the professional to the need for follow-up. When traumatic injuries are diagnosed and treated early, post-traumatic complications may be controlled, allowing conservation of the tooth in oral cavity.
本研究旨在通过临床和影像学分析评估严重牙脱位和再植牙的主要创伤后并发症。
评估了83例年龄在7至55岁之间的患者，这些患者共有180颗外伤牙，包括脱出性脱位（n = 67）、侧向脱位（n = 69）、嵌入性脱位（n = 10）和牙脱位后再植（n = 34）。随访期为24个月。检查的并发症包括：牙髓腔闭塞、牙髓坏死和牙根吸收（炎性和替代性）。此外，还观察了接受牙科治疗前的时间与炎性吸收发展之间的关系。
牙髓坏死是主要并发症，发生在147颗牙齿（82.7%）。所有遭受嵌入性脱位和牙脱位的牙齿均被诊断为牙髓坏死，与其他创伤相比有显著差异（p<0.001/费舍尔精确检验）。20.5%的病例观察到炎性牙根吸收，替代性吸收与牙再植更相关（94.1%），在牙脱位中患病率显著（p<0.001/费舍尔精确检验）。此外，还注意到与牙外伤后不久寻求治疗的患者相比，创伤事件9周后寻求治疗的患者发生炎性吸收的几率高出10倍（优势比检验）。
可以得出结论，牙髓坏死是外伤牙中观察到的主要创伤后并发症，延迟寻求治疗可能会损害严重牙脱位和再植牙的预后。
描述可能影响外伤牙的主要并发症的临床研究对于让公众意识到立即寻求治疗的重要性以及提醒专业人员进行随访的必要性具有重要意义。当创伤性损伤得到早期诊断和治疗时，创伤后并发症可能得到控制，从而使牙齿能够保留在口腔中。
