Rafiee Azade, Moradian Hamid, Ayatollahi Maryam
Department of Pediatric Dentistry, Dental School, Shiraz, Iran.
Transplant Research Center, Shiraz University of Medical Sciences, Shiraz Stem Cell Institute for Cell Therapy and Regenerative Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Dent Res J (Isfahan). 2016 Sep;13(5):458-461. doi: 10.4103/1735-3327.192310.
Intrusive luxation is the most severe type of dental injury with a complex healing sequence. Pulp necrosis, root resorption (surface, inflammatory and replacement resorption), and defects in marginal periodontal bone healing are the main complications. Treatment strategies can be either active, by repositioning (surgical or orthodontic extrusion), or passive, by spontaneous re-eruption based on the thorough evaluation of the case. This paper reports a case of delayed repositioning of severely intruded permanent maxillary central incisors accompanied by complicated crown fractures after 3 months. After thorough clinical and radiographic evaluations, and based on guidelines, the teeth were surgically repositioned and splinted for 6 weeks. One week after the initial intervention, the endodontic treatment for both permanent maxillary incisors were initiated using calcium hydroxide. 6 months later, the teeth were ready for MTA plug and gutta-percha root canal filling. During the follow-up period, the teeth had remained functional and esthetically acceptable. Further yearly observations are planned at least for 5 years.
嵌入性脱位是最严重的牙外伤类型，愈合过程复杂。牙髓坏死、牙根吸收（表面吸收、炎性吸收和替代性吸收）以及边缘牙周骨愈合缺陷是主要并发症。治疗策略可以是积极的，即通过复位（手术或正畸牵引），也可以是消极的，即根据病例的全面评估通过自发再萌出。本文报告1例严重嵌入的上颌恒中切牙在3个月后伴有复杂冠折的延迟复位病例。经过全面的临床和影像学评估，并根据指南，对患牙进行了手术复位并结扎固定6周。初次干预1周后，对上颌两颗恒切牙开始使用氢氧化钙进行根管治疗。6个月后，患牙准备好进行MTA充填和牙胶根管充填。在随访期间, 患牙保持了功能和美观。计划至少再进行5年的年度观察。
