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At least 433 records · Page 24Linked to original sources

Treatment of trauma to the primary and young permanent dentitions.

An overview of the various possibilities for trauma to the primary and young permanent dentition has been presented. Appropriate treatment procedures have been described. Advances in dental science have been great, and dental materials have become superior to what they were just a few years ago. The dentist must never forget the variabilities of human responses to any of the treatment techniques, however, and the dentist must never be dogmatic in approach. The dentist should be able to diagnose, interpret, and alter any of the treatment techniques as more scientific evidence is obtained.

Child↗

A multidisciplinary approach to the treatment of an intruded maxillary permanent incisor complicated by the presence of two mesiodentes.

Treatment of a traumatically intruded maxillary incisor with an immature apex remains controversial. Treatment options include observation, surgical repositioning, or orthodontic forced eruption. Likewise, the ideal timing of surgical removal of a mesiodens is highly controversial: immediate versus delayed intervention. The complications associated with untreated supernumerary teeth include: overretention of primary teeth, delayed eruption of permanent incisors, rotations, impaction, diastema, pulp necrosis and root resorption. Less common sequelae include enlarged follicular sacs, cystic degeneration and nasal eruption. This paper describes another risk factor associated with delayed removal of a mesiodens previously not mentioned in the dental literature, namely potential complications arising from a traumatic injury, in particular intrusion, of the maxillary permanent incisors.

Child↗

Intrusion injuries of primary incisors. Part I: Review and management.

Intrusion injuries commonly occur in the primary dentition. They can be described as luxation injuries resulting from an axially directed impact, which drives the tooth deeper into the alveolar socket. The impact results in compression of and damage to the periodontal ligament as well as injury to the pulp of the intruded incisor. In addition to rendering treatment to the intruded primary tooth, the dentist must also be aware of the possibility of an injury to the developing permanent teeth germs located in close proximity to the roots of the injured primary teeth. This review will discuss the characteristics, implications, and management of intrusion injuries of primary incisors.

Child↗

Intrusion injuries of primary incisors. Part II: Sequelae affecting the intruded primary incisors.

Luxation injuries to incisors, including intrusive displacement, occur with a high frequency in the primary dentition. Intrusion injuries are associated with damage to the pulpal and periodontal structures and possible fracture of the alveolar bone. The pulpal tissue of the intruded tooth sustains a severe shock during displacement, which may be reflected later by sequelae ranging from mild discoloration to pulpal necrosis and infection. Disintegration of pulpal tissue may result in periapical tissue inflammation, which in turn may induce developmental disturbances in the germ of the permanent successor tooth. Additionally, severe injury to the periodontal ligament during intrusion may lead to ankylosis of the primary incisor and consequently to delayed or ectopic eruption of its permanent successor. This article will review the possible sequelae affecting primary incisors following their intrusion.

Alveolar Process↗

Intrusion injuries of primary incisors. Part III: Effects on the permanent successors.

Intrusion injuries of the primary dentition are highly associated with developmental disturbances of their successor teeth. The age of the child at the time of injury, the direction and severity of the intrusion, and the presence of alveolar bone fracture are important variables influencing the effect of primary tooth intrusion on the developing permanent germ. The developmental defects of the permanent successor tooth range from mild alteration in enamel mineralization to severe sequestration of the developing germ. This article will review the developmental anomalies of the permanent incisors induced by intrusion injuries of their predecessors.

Age Factors↗

[Complicated tooth replantation].

The materials and techniques for tooth replantation in presence of complications are discussed on the basis of recent advances in oral medicine and surgery and dentistry. The following complications are examined: mucous and cutaneous wounds, retention of teeth and foreign bodies, bony and radicular fractures with or without tissue loss, root drying, infection. Other problems are also discussed: replantation of deciduous teeth, endodontic therapy, stabilization of replanted teeth, application of orthodontic forces. Some technical principles are presented for a better management of various clinical situations. At last, interesting clinical cases are reported.

Adolescent↗

Trauma to the primary and young permanent dentitions.

It is the responsibility of the dentist to stay current on the latest techniques available to treat traumatic injuries. The charts included provide most of the potential emergency treatment possibilities, recommended follow-up treatment, and final treatment outcomes essential to providing the best care for our child patients. It is also the responsibility of the dentist to use evidence-based research when adopting treatment protocols. It is not appropriate to use anecdotal or single case studies as a basis for adopting treatment protocols. It is very difficult in this area of trauma to come up with good scientific research with adequate sample sizes and long-term data. Dr. J.O. Andreasen has excellent compiled long-term research on trauma. His books, Essentials of Traumatic Injuries to the Teeth and An Atlas of Replantation and Transplantation of Teeth are two very good books for any clinical practice.

Child↗