Department of Oral and Maxillofacial Surgery, Centre of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark.
J Endod. 2019 Dec;45(12S):S52-S56. doi: 10.1016/j.joen.2019.05.013. Epub 2019 Oct 14.
Dental implants are reliable to replace teeth lost because of traumatic dental injury. However, dental implants behave like ankylosed teeth and should not be placed in growing individuals because of the risk of infraposition. This risk may be reduced by ensuring arrested skeletal growth and ideal incisal support. The timing of implant placement may be immediate, early, conventional, or late and is determined by the extent of the trauma, remaining growth, and conditions of the hard and soft tissues. Timing should allow an observation period to properly evaluate the prognosis of concomitantly traumatized neighboring teeth. Orthodontic alignment is often necessary after traumatic dental injury in young individuals to provide symmetric dental conditions around the facial midline, to allow implant placement in the correct 3-dimensional position for the later prosthetic reconstruction, and to ensure sufficient mesiodistal space that leaves a minimum of 1.5 mm of healthy alveolar bone between the future implant and neighboring teeth. Space and stable occlusion should be maintained by bonded retainers and a splint used during the night. A partial prosthesis is usually recommended as a temporary replacement. If a fixed provisional prosthesis is required, it is crucial that it does not interfere with the remaining growth and incisal support and allows proper oral hygiene.
种植牙是一种可靠的方法，可以用来修复因创伤性牙损伤而缺失的牙齿。然而，种植牙的行为类似于骨粘连的牙齿，不应放置在生长中的个体中，因为存在位置过低的风险。通过确保骨骼生长停止和理想的切牙支持，可以降低这种风险。种植体的放置时间可以是即刻、早期、常规或晚期，具体取决于创伤的程度、剩余的生长情况以及软硬组织的状况。放置时间应允许观察期，以便正确评估同时受伤的邻牙的预后。在年轻人发生创伤性牙损伤后，通常需要进行正畸矫正，以提供面部中线周围对称的牙齿状况，以便在正确的三维位置放置种植体，以便为以后的修复重建提供足够的近远中距离，并确保在未来的种植体和邻牙之间留有最小 1.5 毫米的健康牙槽骨。通过夜间使用粘结保持器和夹板来保持空间和稳定的咬合。通常建议使用局部义齿作为临时替代物。如果需要固定临时义齿，则必须确保它不会干扰剩余的生长和切牙支持，并允许进行适当的口腔卫生。
