Traumatic avulsion and delayed replantation of maxillary incisors in an eleven-year-old child

Gokcen Deniz Bayrak
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Abstract

Introduction: Management of dental trauma in pediatric patients requires not only immediate intervention but also long-term follow-up regimen. Especially, avulsion of permanent teeth is the most serious injuries of the tooth, and replantation of teeth must be carried out immediately for good prognosis. Case Report: This article describes the treatment of four anterior maxillary permanent incisors of an 11-year-old boy with history of traumatic avulsion and delayed replantation. The avulsed teeth were kept in unclean and dry conditions for 5 h. The root canal treatment was carried out with mineral trioxide aggregate (MTA). After treatment, the patient was referred to the orthodontic department and two of replanted teeth were extracted orthodontically. The remained replanted teeth were stable and functional position during the four-year follow-up. However, one of teeth showed an excessive root resorption on the last radiographic examination.Conclusion: Although the risk of progressive root resorption and ankloysis is high, delayed replantation of avulsed teeth can be a best choice to avoid early tooth loss. To prevent the complications of delayed replantation, MTA might be used for root canal treatment. Thus, the level of alveolar bone can be preserved till the growth is completed.
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11岁儿童上颌门牙外伤性撕脱及延迟再植一例
儿童牙外伤的处理不仅需要立即干预,而且需要长期的随访治疗。其中,恒牙脱脱是牙齿最严重的损伤,为获得良好的预后,必须立即进行牙齿再植。病例报告:这篇文章描述了一个11岁的男孩,有创伤性撕脱和延迟再植史的上颌前恒门牙的治疗。撕脱后的牙齿在不清洁和干燥的条件下保存5小时。用三氧化二矿骨料(MTA)进行根管治疗。治疗后,患者转诊至正畸科,并拔除2颗再植牙。随访4年,剩余的移植牙位置稳定,功能良好。然而,其中一颗牙齿在最近的x线检查中显示过度的牙根吸收。结论:虽然牙根逐渐吸收和踝关节溶解的风险较高,但延迟再植是避免早期牙脱落的最佳选择。为了防止延迟再植的并发症,MTA可以用于根管治疗。因此,牙槽骨的水平可以保持到生长完成。
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