Haimed Tariq Abu, Abdeltawab Samah S, Kayal Rayyan A, Almotairi Mona H, Zawawi Khalid H
Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
Case Rep Dent. 2023 Nov 30;2023:8750942. doi: 10.1155/2023/8750942. eCollection 2023.
Dental intrusions are a severe type of injury because they impact the neurovascular supply of the tooth as well as the supporting tissues which predispose the tooth to necrosis and root resorption. Management of these injuries requires repositioning of the teeth under close monitoring to avoid complications. The management becomes more comprehensive when an intrusion is combined with other injuries, such as a crown-root fracture. This case report represents a 4-year follow-up of a child who suffered from a concomitant injury of intrusion and complicated crown-root fracture to the maxillary immature permanent central incisors. The management involved a multidisciplinary approach including endodontics, pedodontics, orthodontics, periodontics, and prosthodontics. Given the guidelines of dental trauma and the circumstances of the case, the fractured teeth were root canal treated, filled with a bioceramic plug and gutta-percha, and then restored with posts/cores and temporary crowns. The intrusion was managed initially by passive eruption followed by an active orthodontic eruption, after which the teeth were restored with permanent ceramic crowns. Throughout the course of treatment, the teeth showed no complications of root resorption or ankylosis, although one tooth developed a periapical infection which was managed by apical surgery. At the 4-year follow-up, the teeth revealed healthy periodontium and good esthetics.
牙嵌入是一种严重的损伤类型，因为它会影响牙齿的神经血管供应以及支持组织，使牙齿易于发生坏死和牙根吸收。这些损伤的处理需要在密切监测下对牙齿进行复位，以避免并发症。当嵌入与其他损伤如冠根折合并发生时，处理会变得更加复杂。本病例报告展示了一名儿童上颌未成熟恒中切牙遭受嵌入合并复杂冠根折损伤的4年随访情况。处理采用了多学科方法，包括牙髓病学、儿童牙科学、正畸学、牙周病学和口腔修复学。根据牙外伤指南及病例情况，对折断的牙齿进行根管治疗，用生物陶瓷桩和牙胶充填，然后用桩核和临时冠修复。嵌入伤最初通过被动萌出处理，随后进行主动正畸萌出，之后用永久性陶瓷冠修复牙齿。在整个治疗过程中，牙齿未出现牙根吸收或粘连等并发症，尽管有一颗牙齿发生了根尖感染，通过根尖手术进行了处理。在4年随访时，牙齿显示牙周组织健康，美观效果良好。
