American Journal of Orthodontics and Dentofacial Orthopedics
Original articleEmergency orthodontic treatment after the traumatic intrusive luxation of maxillary incisors
Section snippets
Patient 1
An 8-year-old, quadriplegic girl with cerebral palsy and mental retardation arrived at our department of oral and maxillofacial surgery 9 days after having traumatized her anterior teeth and severely lacerated her lips and gingivae (Fig 1). There was a previous history of trauma to the front teeth. Her overall malocclusion was Class II Division 1, with deep bite and impingement of the mandibular incisors on the palate.
The 4 maxillary incisors had all been severely intrusively luxated. The
Material and methods
A computerized MEDLINE literature search (from 1966 through November 2002) was performed to identify the maximum number of studies in which intrusive luxation was treated by the orthodontic repositioning approach. “Orthodontics” was searched in the subject heading and was crossed with various combinations of the terms “trauma,” “intrusion,” and “luxation.” A library search was also made of the articles cited in the bibliographies of the relevant case reports that were thus discovered.
The
Discussion
The current state of knowledge regarding treatment of intruded teeth is based largely on empirical clinical experience rather than on scientific data. In this qualitative meta-analysis, a thorough literature search sought published articles describing treatment of intruded maxillary incisors by orthodontic repositioning for evidence about this treatment approach. Because of the heterogeneity of the sample group, it was considered invalid to combine the data; nevertheless, some consistent
Conclusions
- 1.
The success rate of orthodontically generated extrusion of intruded teeth was high.
- 2.
Among the teeth with incomplete apices, those that had suffered severe intrusion lost their vitality, whereas almost half of the moderately intruded teeth remained vital.
- 3.
All teeth with completed apices lost their vitality.
- 4.
External root resorption affected more than half of the treated teeth.
- 5.
Loss of marginal bone support was rarely encountered.
- 6.
All teeth that had remained vital showed signs of pulp obliteration.
- 7.
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Cited by (56)
Digital orthodontic extrusion system for complex crown-root fracture of anterior teeth: A technique report
2023, Journal of Prosthetic DentistryOrthodontic treatment after intrusive dislocation and fracture of the maxillary central incisors
2021, American Journal of Orthodontics and Dentofacial OrthopedicsCitation Excerpt :An initial CBCT was not available but was taken subsequently at a later point in treatment. Chaushu et al12 noticed a 96.7% success rate of orthodontic extrusion in patients who had traumatic intrusion when the treatment started between 1 and 90 days after the injury, with most of the first orthodontic examinations taking place up to the third day after the incident.13,14 To not delay the start of the treatment, braces were bonded to start the traction of the maxillary central incisors in the first session because spontaneous eruption is not expected of permanent teeth with closed apexes intruded more than 7 mm in traumatic injuries.15
Combined orthodontic, surgical, and restorative approach to treat a complicated crown-root fracture in a maxillary central incisor
2018, American Journal of Orthodontics and Dentofacial OrthopedicsCitation Excerpt :We suggest that a crown-root ratio of approximately 1:1 is favorable for maintaining periodontal support, although this has not been studied extensively.44 In the literature, several orthodontic appliances have been used for extrusion: (1) a removable Hawley plate with self-supporting spring applied to a small attachment bonded to the tooth, (2) a removable Hawley plate with elastic traction applied to a small attachment bonded to the tooth, (3) a fixed multibracket appliance bonded to the affected tooth and adjacent teeth with elastic traction or superelastic nickel-titanium wire, (4) a fixed multibracket mandibular appliance with vertical intermaxillary elastic traction to a small bonded attachment on the affected tooth, (5) a self-supporting heavy labial arch slotted into the horizontal tubes of banded first molars with a palatal arch and ligation to the attachment with a steel ligature wire, and (6) a rigid wire frame bonded to the adjacent teeth with elastic traction applied to the small bonded attachment on the tooth.45 In our patient, in addition to extrusion of the maxillary right central incisor, we also wanted to correct the distal crown angulations of both lateral incisors.
The pediatric dental trauma patient: Interdisciplinary collaboration between the orthodontist and pediatric dentist
2016, Seminars in OrthodonticsCitation Excerpt :In all instances, the interdisciplinary team must be able to communicate to achieve a mutually agreed upon a course of action that maximizes each individual member’s skillsets and the best opportunities for success. In cases when orthodontics are favored, the orthodontist may be the most skilled to apply directional forces to resolve displaced teeth as well as the best individual to take the lead in coordinating care.5 The team may decide to have the patient complete follow-up appointments at one specialist’s dental practice location rather than another due to practicality.
Physical properties of root cementum: Part 24. Root resorption of the first premolars after 4 weeks of occlusal trauma
2014, American Journal of Orthodontics and Dentofacial OrthopedicsThe ortho-endo interface
2014, Endodontics: Fourth Edition