Cork University Dental School & Hospital, University College Cork, Ireland.
Eur J Paediatr Dent. 2018 Jun;19(2):101-104. doi: 10.23804/ejpd.2018.19.02.03.
Traumatic intrusion is a luxation type of injury where the tooth is displaced along the axis of the tooth, into the alveolus. This injury is regarded as serious because of the tissue damage that it causes. The traumatic movement is associated with severe damage to the periodontal ligament, pulpal tissue, root and alveolar socket. Despite its severity, the rare occurrence of this injury in permanent teeth has resulted in limited studies of immature and mature permanent incisors. The purpose of this paper is to review this luxation injury of permanent immature incisors, and to describe its diagnosis, treatment and management. In particular, we describe the repositioning strategies used in cases of intrusion injury. These include (i) monitoring spontaneous re-eruption, (ii) active orthodontic repositioning and (iii) surgical repositioning. Firstly, monitoring spontaneous re-eruption is observing and waiting for the intruded tooth to return to its original position. This process is not a normal developmental eruption and the outcome is not always predictable, nor is the time needed for this to happen. Secondly, active orthodontic repositioning is used to describe the process of rapidly moving the intruded tooth to its original position with the aid of an orthodontic appliance. Active orthodontic repositioning is often misunderstood as normal orthodontic movement. Orthodontic movement allows for periodontal ligament remodelling, using light intermittent forces. In contrast the active orthodontic repositioning used to move intruded incisors is rapid, and the primary aim is to achieve correct tooth position as rapidly as possible. Thirdly, surgical repositioning uses surgical intervention to bring the tooth back to its original position. A case of an intruded immature permanent incisor is presented, with a particular emphasis on these critical decisions on repositioning and showing the use of the three modalities of treatment in sequence, in order to achieve an outcome.
创伤性嵌入是一种牙齿沿牙齿轴向移位到牙槽骨中的脱位类型。这种损伤被认为很严重，因为它会造成组织损伤。创伤性运动与牙周韧带、牙髓组织、牙根和牙槽骨的严重损伤有关。尽管这种损伤很严重，但在恒牙中很少发生，导致对未成熟和成熟恒牙的研究有限。本文旨在回顾恒牙未成熟切牙的这种脱位损伤，并描述其诊断、治疗和管理。特别是，我们描述了用于嵌入损伤的复位策略。这些策略包括(i)监测自发性再萌出，(ii)主动正畸复位和(iii)手术复位。首先，监测自发性再萌出是观察和等待嵌入的牙齿回到原来的位置。这个过程不是正常的发育性萌出，结果并不总是可预测的，也不知道需要多长时间才能发生。其次，主动正畸复位用于描述借助正畸矫治器快速将嵌入的牙齿移动到原来位置的过程。主动正畸复位常常被误解为正常的正畸运动。正畸运动允许牙周韧带重塑，使用轻间歇性力量。相比之下，用于移动嵌入切牙的主动正畸复位是快速的，主要目的是尽快达到正确的牙齿位置。第三，手术复位使用手术干预将牙齿恢复到原来的位置。本文介绍了一个嵌入未成熟恒牙的病例，特别强调了这些关于复位的关键决策，并展示了三种治疗方式的顺序使用，以达到治疗效果。
