de Sá Maria Ab, Nunes Eduardo, de Souza Gruppioni Côrtes Maria I, Silveira Frank F
Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Int J Clin Pediatr Dent. 2019 Mar-Apr;12(2):160-163. doi: 10.5005/jp-journals-10005-1612.
Among traumatic dental injuries, intrusive dislocation is considered to be one of the most serious injuries. Despite the high success rate in complacent patients, the traditional technique of calcium hydroxide inoculation has drawbacks. The good antimicrobial and sealing properties combined with excellent biocompatibility and high success rates of the mineral trioxide aggregate (MTA) encourage its use.
The objective of this study was to report a successful case of intrusive dislocation in a short time with a follow-up of eight years.
A patient, seven years of age, presented intrusive dental dislocation, confirmed by radiographic examination, which revealed besides axial displacement of the central incisor towards the bone, incomplete root development. The passive repositioning was chosen as the treatment modality. After cleansing of the root canal, therapy with hydroxide paste was performed for 30 days, and then the apex was closed using an artificial barrier made with apical MTA buffer to facilitate root canal obturation.
Clinical and radiographic signs at 6 months and 8 years of preservation evidence the success of the therapy.
Teeth with incomplete root formation when traumatized may have their development process interrupted; consequently their root canals remained ample with thin and fragile walls and the open apex which represents a great challenge to the accomplishment of endodontic therapy. The process of apexification with MTA as in this case is an alternative to traditional therapy based on calcium hydroxide, conferring a faster treatment and a decrease in the odds of fracture of the tooth since from the confection of the apical barrier there is a possibility of being the same restored at an early stage.
de Sá MAB, Nunes E, A Short Time Period in the Treatment of an Open Apice Intruded Tooth: An 8-year Follow-up. Int J Clin Pediatr Dent 2019;12(2):160-163.
在牙外伤中,嵌入性脱位被认为是最严重的损伤之一。尽管在配合良好的患者中成功率较高,但传统的氢氧化钙植入技术存在缺点。矿物三氧化物凝聚体(MTA)具有良好的抗菌和密封性能,以及出色的生物相容性和高成功率,促使人们使用它。
本研究的目的是报告一例在短时间内成功治疗嵌入性脱位并随访八年的病例。
一名七岁患者出现牙嵌入性脱位,经影像学检查确诊,该检查显示除中切牙向骨内轴向移位外,牙根发育不完全。选择被动复位作为治疗方式。根管清洁后,用氢氧化钙糊剂治疗30天,然后使用由根尖MTA缓冲材料制成的人工屏障封闭根尖,以利于根管充填。
保存6个月和8年时的临床和影像学征象证明了治疗的成功。
牙根发育不完全的牙齿在受外伤时,其发育过程可能会中断;因此,它们的根管宽大,壁薄且脆弱,根尖开放,这对牙髓治疗的完成构成了巨大挑战。如本病例中使用MTA进行根尖诱导成形术是基于氢氧化钙的传统治疗的一种替代方法,可实现更快的治疗,并降低牙齿折断的几率,因为从制作根尖屏障开始,就有可能在早期恢复牙齿。
德·萨MAB,努内斯E,《开放根尖嵌入牙的短期治疗:八年随访》。《国际临床儿科牙科学杂志》2019年;12(2):160 - 163。