Endodontic and restorative management of an adult with avulsion of multiple teeth: A case report with 5 years and 9 months of follow-up

IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
Florin Eggmann, Andreas Filippi, Khaled Mukaddam
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Abstract

Simultaneous avulsion of four or more teeth is a rare event. This case report examines the dental care given to an adult who, during a bicycle accident, experienced the avulsion of a mandibular incisor as well as all of his maxillary incisors. In the immediate aftermath of the accident, four out of the five incisors were located, promptly collected, and stored in a tooth rescue box, all within a 20-min window. Replantation and splinting were performed on the day of the accident. Endodontic treatment involved sequential intracanal dressing with an antibiotic–corticosteroid paste followed by calcium hydroxide prior to root canal obturation. 3 months post-accident, signs of external replacement resorption (ERR) began to appear in all the replanted teeth. The gap created by the missing maxillary central incisor was managed with a three-unit fixed dental prosthesis, despite the onset of ERR in the incisors used as abutment teeth. Regular follow-ups showed a relatively slow ERR progression rate over a span of nearly 6 years. The patient expressed satisfaction with both the esthetic and functional outcomes. This case, marked by multiple avulsions, underscores the importance of immediate and appropriate intervention alongside the imperative for carefully considered long-term management strategies. Given the decelerated bone remodeling rate in adults, ERR generally progresses at a slower pace than in children. Accordingly, this case demonstrates the viability of retaining replanted teeth over the long term, even when these teeth have been subjected to nonphysiological storage for extended durations, a factor known to impede periodontal healing.

成人多牙撕脱的根管治疗和修复治疗:随访5年9个月1例。
同时发生四颗或四颗以上牙齿的撕脱是很罕见的。本病例报告检查了一个成年人的牙齿护理,他在一次自行车事故中,经历了下颚门牙和所有上颌门牙的撕脱。事故发生后,5个门牙中有4个被找到,并被及时收集,并储存在一个牙齿抢救箱中,所有这些都在20分钟内完成。在事故当天进行了再植和夹板手术。根管治疗包括在根管封闭前用抗生素-皮质类固醇糊剂进行连续的管内敷料,然后使用氢氧化钙。事故发生后3个月,所有的再植牙均开始出现外牙吸收(ERR)的迹象。尽管作为基牙的切牙出现ERR,但上颌中切牙缺失造成的间隙仍采用三单元固定义齿修复。定期随访显示,在近6年的时间里,ERR的进展速度相对较慢。患者对美观和功能结果都表示满意。该病例以多发撕脱为特征,强调了立即和适当干预的重要性,同时也强调了仔细考虑长期管理策略的必要性。考虑到成人的骨重塑速度减慢,ERR的进展速度通常比儿童慢。因此,这个病例证明了长期保留移植牙齿的可行性,即使这些牙齿已经遭受了长时间的非生理储存,这是一个已知的阻碍牙周愈合的因素。
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来源期刊
Dental Traumatology
Dental Traumatology 医学-牙科与口腔外科
CiteScore
6.40
自引率
32.00%
发文量
85
审稿时长
6-12 weeks
期刊介绍: Dental Traumatology is an international journal that aims to convey scientific and clinical progress in all areas related to adult and pediatric dental traumatology. This includes the following topics: - Epidemiology, Social Aspects, Education, Diagnostics - Esthetics / Prosthetics/ Restorative - Evidence Based Traumatology & Study Design - Oral & Maxillofacial Surgery/Transplant/Implant - Pediatrics and Orthodontics - Prevention and Sports Dentistry - Endodontics and Periodontal Aspects The journal"s aim is to promote communication among clinicians, educators, researchers, and others interested in the field of dental traumatology.
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