Jacobs S G
Orthodontic Department, Royal Dental Hospital of Melbourne, Victoria, Australia.
Aust Orthod J. 1995 Mar;13(4):213-8.
A case is reported in which an intruded incisor was initially treated by an endodontic dressing with calcium hydroxide and then extruded using a removable orthodontic appliance. A follow-up examination seven years after completion of endodontic therapy and bleaching showed a favourable response. A review of the relevant literature indicates that intrusion occurs in five to twelve per cent of luxation cases. In this type of injury maximum damage occurs to the pulp and all supporting structures because the tooth is driven into the alveolar process. Complications which have been reported include: pulp necrosis, apical radiolucencies, partial or total pulp calcification, root resorption (surface, inflammatory or replacement), marginal periodontal bone breakdown, and arrested or disturbed root development. The prognosis for pulp survival after intrusion is much more favourable for teeth with incomplete root formation than for teeth with complete root formation. Treatment options available to bring an intruded tooth into alignment are: to await spontaneous re-eruption which may occur if root formation is incomplete, uncovering of the intruded crown, orthodontic extrusion which is allied with gentle luxation if the tooth does not move, and immediate surgical repositioning.
报告了一例病例，其中一颗嵌入性门牙最初采用氢氧化钙进行根管内敷料治疗，然后使用可摘正畸矫治器将其挤出。根管治疗和漂白完成七年后的随访检查显示效果良好。对相关文献的回顾表明，嵌入性损伤发生在5%至12%的牙脱位病例中。在这种类型的损伤中，由于牙齿被挤入牙槽突，牙髓和所有支持结构会受到最大程度的损害。已报道的并发症包括：牙髓坏死、根尖透射区、部分或完全牙髓钙化、牙根吸收（表面、炎症性或替代性）、边缘牙周骨破坏以及牙根发育停滞或受阻。与牙根完全形成的牙齿相比，牙根未完全形成的嵌入性牙齿牙髓存活的预后要好得多。使嵌入性牙齿复位对齐的治疗选择包括：等待牙根未完全形成时可能发生的自发再萌出、暴露嵌入的牙冠、正畸挤出（如果牙齿不动则联合轻柔的松动）以及立即进行手术复位。
