Private practice, Thessaloniki, Greece.
Department of Pediatric Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Dent Traumatol. 2023 Aug;39(4):392-398. doi: 10.1111/edt.12828. Epub 2023 Feb 19.
Replantation is the treatment of choice for avulsed permanent teeth; ankylosis and cervical root resorption are among survival complications. A 9.5-year-old boy presented with an avulsed maxillary permanent central incisor with an open root apex following a school accident. The tooth was kept in milk, after a dry time of 15-20 min. Its replantation was performed 60 min after the accident. At 8 months, apexification with apical plug was attempted upon radiographic evidence of apical periodontitis. Ankylosis sound with infraocclusion and radiographic evidence of external cervical root resorption (ECR) were evident at 3 years and 3 months. At the patient's return one year later with esthetic concerns (2 mm infraocclusion) there was a 5 mm diameter ECR cavity. After intentional atraumatic extraction the resorptive cavity was debrided and restored with Biodentine; subsequently the tooth was reimplanted and splinted at an extruded position. At the 10-year follow up since the first avulsion the tooth remains esthetically pleasing, asymptomatic, non-ankylotic and functional. The present case supports intentional replantation as an option in managing infraoccluded teeth with advanced ECR.
再植术是治疗外伤性脱位恒牙的首选方法；而发生愈合、根吸收是其存活的并发症。一位 9.5 岁男孩因学校事故导致上颌恒中切牙脱位，离体牙根尖孔敞开，牙随之被放入牛奶中，干燥时间为 15-20 分钟。受伤后 60 分钟进行再植。在出现根尖周炎的放射影像学证据后，8 个月时进行根尖诱导成形术，用根尖塞治剂封闭根尖孔。3 年 3 个月时，出现低咬合伴骨性粘连，并有放射影像学证据显示外吸收（ECR）。1 年后患者因美观问题（低咬合 2mm）复诊，此时发现 ECR 腔为 5mm 直径。进行无创伤性拔牙后，用 Biodentine 清创并修复吸收腔，然后将牙齿重新植入并固定在突出位置。第一次脱位后 10 年的随访显示，牙齿美观、无症状、无骨性粘连且功能正常。本病例支持将意向性再植作为处理低咬合伴严重 ECR 牙的一种选择。
