Abstract:
Objective To observe the clinical outcomes of traumatically intruded young permanent teeth after using a minimal invasive orthodontic repositioning method.
Methods Eight patients aged from 7 to 11 years old presenting dental trauma were admitted to our department. A total of 11 injured maxillary incisors, with 9 severely intruded and 2 moderately intruded. All teeth were observed for spontaneous re-eruption for at least 1 month, before initiating orthodontic repositioning. Minimal invasive orthodontic repositioning were possible using the following method: (1) "2 × 4" nickel titanium wire appliance: single tooth moderately intruded with adjacent teeth erupted above 3/4; (2) removable appliance: severely and vertically intruded tooth, with adjacent teeth erupted less than 1/2 or traumatically dislocated; (3) removable appliance and "2 × 4" nickel titanium wire appliance: severely buccal or palatal intruded tooth, with adjacent teeth erupted less than 1/2 or traumatically dislocated. During the re-eruption status, pulp necrosis, loss of gingival attachment, marginal bone loss, root resorption and the condition of adjacent teeth were observed.
Results (1) Re-eruption status: all the teeth were repositioned in good alignment with the adjacent teeth; (2) root resorption: 4 teeth showed mild root resorption. 2 teeth showed evidence of obvious periapical and lateral radiolucency before the repositioning, which were ceased and healed at the end of the treatment; (3) marginal bone loss: 2 teeth showed mild marginal bone loss; (4) pulp status: 3 mature teeth were root-treated with calcium hydroxide paste before the repositioning, 4 immature teeth were treated during the treatment, and 4 teeth maintained pulp vitality, one tooth showed root canal calcification.
Conclusions If the traumatically intruded teeth show no signs of re-eruption, depending on the direction of intrusion, the stage of eruption of the adjacent teeth and the severity of the trauma, immediate repositioning should be initiate. "2 × 4" nickel titanium wire appliance, removable appliance or even the use of both in one unit should be a feasible choice to effectively reposition dislocated tooth, avoid root absorption, reduce the occurrence of marginal bone loss, and maintained pulp vitality.
Key words:
Dentition permanent,
Tooth intrusion,
Minimally invasive,
Orthodontic extrusion,
Root absorption
Dan Xu, Xushun He, Zhixiong Gao, Qi Zeng, Yantao Liang, Fang Huang. Clinical observation on minimally invasive orthodontic extrusion of intruded immature central incisors[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2018, 12(01): 37-47.