Kim H J, Kim Y I, Min K S
Department of Conservative Dentistry, Pusan National University Hospital, Busan, Korea Department of Conservative Dentistry, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju, Korea.
Department of Orthodontics, School of Dentistry, Pusan National University Hospital, Busan, Korea.
Eur J Paediatr Dent. 2017 Mar;18(1):27-31. doi: 10.23804/ejpd.2017.18.01.06.
Severe damage to the tooth, periodontal ligament, and pulpal tissue often occurs with intrusive luxation, and outcomes are quite unpredictable because of the variable ways in which the injury may occur, which influences both the choice of treatment and prognosis.
This case presents a novel method for the management of an intruded permanent maxillary central incisor with an immature apex. At first, watchful waiting for spontaneous re-eruption was the chosen treatment option. A palatal gingivectomy was performed and endodontic access was established, following which, an intracanal medicament of calcium hydroxide was applied. A root canal treatment was completed, and apexification with mineral trioxide aggregate was performed. Re-eruption failed to reach completion, so complete repositioning was performed with the aid of orthodontics for two months.
The present case illustrates the partial re-eruption of a severely intruded immature permanent tooth with the use of interim medication in the root canal. This case also shows complete re-eruption with the aid of timely orthodontic repositioning after apexification.
牙齿嵌入性脱位常导致牙齿、牙周膜和牙髓组织的严重损伤，由于损伤发生方式的不同，其预后难以预测，这会影响治疗方法的选择和预后。
本病例介绍了一种治疗根尖未发育完成的上颌恒中切牙嵌入性脱位的新方法。起初，选择密切观察等待牙齿自然再萌出作为治疗方案。进行了腭侧牙龈切除术并建立了根管入口，随后，在根管内应用氢氧化钙药物。完成根管治疗后，使用三氧化矿物凝聚体进行根尖诱导成形术。牙齿未能完全再萌出，因此借助正畸治疗进行了两个月的完全复位。
本病例表明，通过在根管内使用临时药物，严重嵌入的未成熟恒牙可部分再萌出。该病例还显示，根尖诱导成形术后及时进行正畸复位可实现完全再萌出。
