International Journal of Clinical Pediatric Dentistry

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VOLUME 12 , ISSUE 2 ( March-April, 2019 ) > List of Articles

CASE REPORT

A Short Time Period in the Treatment of an Open Apice Intruded Tooth: An 8-year Follow-up

Maria AB de Sá, Eduardo Nunes, Maria I de Souza Gruppioni Côrtes, Frank F Silveira

Keywords : Dental trauma, Intrusive luxation, Permanent tooth, Treatment

Citation Information : de Sá MA, Nunes E, Côrtes MI, Silveira FF. A Short Time Period in the Treatment of an Open Apice Intruded Tooth: An 8-year Follow-up. Int J Clin Pediatr Dent 2019; 12 (2):160-163.

DOI: 10.5005/jp-journals-10005-1612

License: CC BY-NC 4.0

Published Online: 01-04-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Aim: Among traumatic dental injuries, intrusive dislocation is considered to be one of the most serious injuries. Despite the high success rate in complacent patients, the traditional technique of calcium hydroxide inoculation has drawbacks. The good antimicrobial and sealing properties combined with excellent biocompatibility and high success rates of the mineral trioxide aggregate (MTA) encourage its use. Background: The objective of this study was to report a successful case of intrusive dislocation in a short time with a follow-up of eight years. Case description: A patient, seven years of age, presented intrusive dental dislocation, confirmed by radiographic examination, which revealed besides axial displacement of the central incisor towards the bone, incomplete root development. The passive repositioning was chosen as the treatment modality. After cleansing of the root canal, therapy with hydroxide paste was performed for 30 days, and then the apex was closed using an artificial barrier made with apical MTA buffer to facilitate root canal obturation. Conclusion: Clinical and radiographic signs at 6 months and 8 years of preservation evidence the success of the therapy. Clinical relevance: Teeth with incomplete root formation when traumatized may have their development process interrupted; consequently their root canals remained ample with thin and fragile walls and the open apex which represents a great challenge to the accomplishment of endodontic therapy. The process of apexification with MTA as in this case is an alternative to traditional therapy based on calcium hydroxide, conferring a faster treatment and a decrease in the odds of fracture of the tooth since from the confection of the apical barrier there is a possibility of being the same restored at an early stage.


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  1. Traebert J, Peres MA, et al. Prevalence of traumatic dental injury and associated factors among 12-year-old school children in Florianópolis, Brazil. Dent Traumatol 2003;19:15–18. DOI: 10.1034/j.1600-9657.2003.00138.x.
  2. Andreasen JO, Andreasen FM. Dental traumatologi: quo vadis. Taudlaegebladet 1989;93:381–384.
  3. Cortes MI, Marcenes W, et al. Impact of traumatic injuries to the permanent teeth on the oral health-related quality of life in 12-14-year-old children. Community Dent Oral Epidemiol 2002;30(3):193–198. DOI: 10.1034/j.1600-0528.2002.300305.x.
  4. Ramos-Jorge ML, Bosco VL, et al. The impact of treatment of dental trauma on the quality of life of adolescents. a case-control study in southern Brazil. Dent Traumatol 2007;23:114.119. DOI: 10.1111/j.1600- 9657.2005.00409.x.
  5. Petti S, Glendor U, et al. World traumatic dental injury prevalence and incidence, a meta-analysis-one billion living people have had traumatic dental injuries. Dent Traumatol 2018;34(2):71.86. DOI: 10.1111/edt.12389.
  6. Schatz JP, Hakeberg M, et al. Prevalence of traumatic injuries to permanent dentition and its association with overjet in a Swiss child population. Dent Traumatol 2013;29:110.114. DOI: 10.1111/j.1600-9657.2012.01150.x.
  7. Andreasen JO, Andreasen FM, et al. Textbook and color atlas of traumatic injuries to the teeth, 4th ed. Copenhagen: Munksgaard, 2007.
  8. Windley W, Teixeira F, et al. Disinfection of immature teeth with a triple antibiotic paste. J Endod 2005;31(6):439.443. DOI: 10.1097/01. don.0000148143.80283.ea.
  9. Andreasen JO, Andreasen FM. Textbook and color Atlas of Traumatic Injuries to the Teeth, 3rd ed. Copenhagen: Munksgaard; 1994.
  10. Dumsha TC. Traumatic injuries to teeth. Dent Clin North Am 1995;39:85.87.
  11. Andresen JO, Bakland LK, et al. Traumatic intrusion of permanent teeth. Part 2. A clinical study of the effect of preinjury and injury factors, such as sex, age, stage of root development, tooth location, and extent of injury including number of intruded teeth on 140 intruded permanent teeth. Dental Traumatol 2006;22:90.98.
  12. Faus-Matoses V, Martinez-Vinarta M, et al. Treatment of multiple traumatized anterior teeth associated with an alveolar bone fracture in a 20-year-old patient: a 3-year follow up. J Clin Exp Dent 2014;6(4):425.429. DOI: 10.4317/jced.51374.
  13. Thakur S, Thakur NS. A 5-year follow-up case of multiple intrusive luxative injuries. Dent Hypotheses 2012;3(3):118.120. DOI: 10.4103/2155-8213.103935.
  14. Al Badri S, Kinirons M, et al. Factors affecting resorption in traumatically intruded permanent incisors in children. Dent Traumatol 2002;18:73.76. DOI: 10.1034/j.1600-9657.2002.180205.x.
  15. Sheehy EC, Roberts GJ. Use of calcium hydroxide for apical barrier formation and healing in non-vital immature permanent teeth: a review. Br Dent J 1997;183:241.246. DOI: 10.1038/sj.bdj.4809477.
  16. Rafter M. Apexification: a review. Dent Traumatol 2005;21(1):1.8. DOI: 10.1111/j.1600-9657.2004.00284.x.
  17. Andreasen JO, Farik B, et al. Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dent Traumatol 2002;18:134.137. DOI: 10.1034/j.1600-9657.2002.00097.x.
  18. Batur YB, Erdemir U, et al. The long-term effect of calcium hydroxide application on dentin fracture strength of endodontically treated teeth. Dent Traumatol 2013;29:461.464. DOI: 10.1111/edt.12037.
  19. Bonte E, Beslot A, et al. MTA vs Ca(OH)2 in apexification of non-vital immature permanent teeth: a randomized clinical trial comparison. Clin Oral Investig 2015;19:1381.1388. DOI: 10.1007/s00784-014-1348-5.
  20. Torabinejad M, Ford TR, et al. Tissue reaction to implanted root-end filling materials in the tibia and mandible of guinea pigs. J Endod 1998;24:468.471. DOI: 10.1016/S0099-2399(98)80048-4.
  21. Damle SG, Bhattal H, et al. Apexification of anterior teeth: a comparative evaluation of mineral trioxide aggregate and calcium hydroxide paste. J Clin Pediatr Dent 2012;36:263.268. DOI: 10.17796/jcpd.36.3.02354g044271t152.
  22. Nicoloso GF, Potter IG, et al. A comparative evaluation of endodontic treatments for immature necrotic permanent teeth based on clinical and radiographic outcomes: a systematic review and meta-analysis. Int J Paediatr Dent 2017;27:217.227. DOI: 10.1111/ipd.12261.
  23. Ree MH, Schwartz RS. Long-term success of nonvital, immature permanent incisors treated with a mineral trioxide aggregate plug and adhesive restorations: a case series from a private endodontic practice. J Endod 2017;43(8):1370.1377. DOI: 10.1016/j.joen.2017.02.017.
  24. Skaare AB, Jacobsen I. Dental injuries in Norwegians aged 7-18 years. Dent Traumatol 2003;19:67.67. DOI: 10.1034/j.1600- 9657.2003.00133.x.
  25. Andreasen JO, Bakland LK, et al. Traumatic intrusion of permanent teeth. Part 1. An epidemiological study of 216 intruded permanent teeth. Dent Traumatol 2006;22:83.89. DOI: 10.1111/j.1600- 9657.2006.00421.x.
  26. Andreasen JO, Bakland LK, et al. Traumatic intrusion of permanent teeth. Part 3. A clinical estudy of the effect of treatment variables such as treatement delay, method of repositioning, type of splint, length of splinting and antibiotics on 140 teeth. Dent Traumatol 2006;22:99.111. DOI: 10.1111/j.1600-9657.2006.00423.x.
  27. Flores MT, Andersson L, et al. Guidelines for the management of traumatic injuries. I. Fractures and luxations of permanent teeth. Dent Traumatol 2007;23:66.71. DOI: 10.1111/j.1600-9657.2007. 00592.x.
  28. Albadri S, Zaitoun H, et al. UK National Clinical Guidelines in Paediatric Dentistry: treatment of traumatically intruded permanent incisor teeth in children. Int J Paediatr Dent 2010;20(Suppl 1):1.2. DOI: 10.1111/j.1365-263X.2010.01085.x.
  29. Diangelis AJ, Andreasen JO, et al. International Association of Dental Traumatology Guidelines for the management of traumatic dental injuries. 1. Fractures and luxations of permanent teeth. Dent Traumatol 2012;28:2.12. DOI: 10.1111/j.1600-9657.2011.01103.x.
  30. Chan AW, Cheung GS, et al. Different treatment outcomes of two intruded permanent incisors. a case report. Dent Traumatol 2001;17:275.280. DOI: 10.1034/j.1600-9657.2001.170606.x.
  31. Cunha RF, Pavarini A, et al. Influence of surgical repositioning of mature permanent dog teeth following experimental intrusion: a histological assessment. Dent Traumatol 2002;18:304.308. DOI: 10.1034/j.1600-9657.2002.00117.x.
  32. Andreasen FM, Vestergaard Pedersen B. Prognosis of luxated permanent teeth. the development of pulp necrosis. Endod Dent Traumatol 1985;1:207.220. DOI: 10.1111/j.1600-9657.1985.tb00583.x.
  33. Haapasalo M, Endal U. Internal inflammatory root resorption: the unknown resorption of the tooth. Endodontic Topics 2006;12:60.79. DOI: 10.1111/j.1601-1546.2008.00226.x.
  34. Majorana A, Bardellini E, et al. Root resorption in dental trauma: 45 cases followed for 5 years. Dent Traumatol 2003;19:262.265. DOI: 10.1034/j.1600-9657.2003.00205.x.
  35. Cveck M. Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with guttapercha. Endod Dent Traumatol 1992;8:45.55. DOI: 10.1111/j.1600-9657.1992.tb00228.x.
  36. Rafter M. Apexification: a review. Dent Traumatol 2005;21:1.8. DOI: 10.1111/j.1600-9657.2004.00284.x.
  37. Koenigs JF, Heller AL, et al. Induced apical closure ofpermanent teeth in adult primates using a resorbable form oftricalcium phosphate ceramic. J Endod 1975;1:102.106. DOI: 10.1016/S0099-2399(75)80026- 4.
  38. Hachmeister DR, Schindler WG, et al. The sealing ability and retention characteristics of mineral trioxide aggregate in a model of apexification. J Endod 2002;28:386.390. DOI: 10.1097/00004770- 200205000-00010.
  39. Simon S, Rilliard F, et al. The use of mineral trioxide aggregate in one-visit apexification treatment: a prospective study. Int Endod J 2007;40:186.197. DOI: 10.1111/j.1365-2591.2007.01214.x.
  40. De Jesus Soares A, Yuri Nagata J, et al. Apexification with a new intra-canal medicament: a multidisciplinary case report. Iran Endod J 2012;7(3):165.170.
  41. Khalilak Z, Vali T, et al. The effect of one-step or two-step MTA plug and tooth apical width on coronal leakage in open apex teeth. Iran Endod J 2012;7(1):10.14.
  42. Leonardo MR, Silveira FF, et al. Calcium hydroxide root canal dressing. Histopathological evaluation of periapical repair at different time periods. Braz Dent J 2002;13(1):17.22.
  43. Andreasen JO, Andreasen FM. Intrusive luxation. In: Andreasen JO, Andreasen FM, ed. Textbook and Color Atlas of Traumatic Injuries to the Teeth, 4th ed. Oxford, UK: Wiley-Blackwell; 2007. pp. 428.43.
  44. Gomes GB, da Costa CT, et al. Traumatic intrusion of permanent teeth: 10 years follow-up of 2 cases. Dent Traumatol 2013 Apr;29(2):165.169. DOI: 10.1111/j.1600-9657.2011.01105.x.
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