A retrospective study on the prognosis of retaining injured deciduous teeth after intrusive luxation in 26 cases

doi:10.19438/j.cjoms.2021.02.013

Abstract

Abstract: PURPOSE: To analyze the prognosis of retaining injured deciduous teeth after intrusion and the related factors to prognosis. METHODS: This was a retrospective study of patients diagnosed as deciduous tooth intrusion treated from March 2018 to October 2019. According to the inclusive and exclusive criteria, the data of 36 intruded teeth from 26 patients were selected. The occurrence of re-eruption and pulp prognosis were recorded, their relevance to the severity of intrusion and patients' age was evaluated. The data was analyzed using SPSS 23.0 software package. RESULTS: There were 33 teeth treated with watchful waiting policy. 97% re-erupted spontaneously, 54.6% re-erupted completely and 42.4% partially re-erupted. Only one tooth developed ankylosis. During the follow-up period, 42.4% of the observed teeth suffered from pulp necrosis/infection related resorption, and the remaining showed no clinical symptoms. No obliteration was observed among the teeth. Age and the degree of intrusion had no significant influence on tooth re-eruption, but the degree of intrusion had significant influence on pulp prognosis(P<0.05). There were 3 teeth treated with surgical reposition, without preventive pulp treatment, external root resorption happened in all these cases. CONCLUSIONS: For deciduous tooth intrusion, re-eruption can be expected in most watchful waiting cases regardless of age and the intrusion severity, while the prognosis of pulp was correlated with the degree of intrusion.

Key words: Deciduous teeth, Traumatic dental injury, Intrusion, Retaining teeth, Watchful waiting policy, Surgical reposition

CLC Number:

R788

SHENG Kai, LAI Guang-yun, DING Qin, WANG Jun. A retrospective study on the prognosis of retaining injured deciduous teeth after intrusive luxation in 26 cases[J]. China Journal of Oral and Maxillofacial Surgery, 2021, 19(2): 167-172.

References

[1] 秦满. 乳牙外伤治疗原则与国际牙外伤学会相关指南解析[J].中华口腔医学杂志, 2019, 54(6): 429-432.
[2] Diab M, elBadrawy HE. Intrusion injuries of primary incisors. Part I: Review and management[J]. Quintessence Int, 2000, 31(5): 327-334.
[3] Carvalho V, Jacomo DR, Campos V.Frequency of intrusive luxation in deciduous teeth and its effects[J]. Dent Traumatol, 2010, 26(4): 304-307.
[4] Andreasen JO, Andreasen FM, Andersson L.Textbook and color atlas of traumatic injuries to the teeth[M]. 4th Ed. Copenhagen: Munksgaard, 2007: 556-588.
[5] Ravn JJ.Developmental disturbances in permanent teeth after intrusion of their primary predecessors[J]. Scand J Dent Res, 1976, 84(3):137-141.
[6] von Arx T. Deciduous tooth intrusions and the odontogenesis of the permanent teeth. Developmental disorders of the permanent teeth following intrusion injuries to the deciduous teeth[J]. Schweiz Monatsschr Zahnmed, 1995, 105(1): 11-17.
[7] Borum MK, Andreasen JO.Sequelae of trauma to primary maxillary incisors. I. Complications in the primary dentition[J]. Endod Dent Traumatol, 1998, 14(1): 31-44.
[8] Altun C, Cehreli ZC, Güven G, et al.Traumatic intrusion of primary teeth and its effects on the permanent successors: a clinical follow-up study[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 107(4): 493-498.
[9] Brown DA, Kodama R, Yacobi R, et al.Intrusive luxation: diagnosis, complications and treatment[J]. Ont Dent, 1985, 62(6): 12-18.
[10] Ravn JJ.Sequelae of acute mechanical traumata in the primary dentition. A clinical study[J]. ASDC J Dent Child,1968, 35(4): 281-289.
[11] 张彦喜, 吴妍慧, 姚东升, 等. 拔除与保留犬挫入性乳牙对继承恒牙影响的实验研究[J]. 中华口腔医学杂志, 2018, 53(5): 344-350.
[12] Thylstrup A, Andreasen JO.The influence of traumatic intrusion of primary teeth on their permanent successors in monkeys. A macroscopic, polarized light and scanning electron microscopic study[J]. J Oral Pathol, 1977, 6(5): 296-306.
[13] Croll TP, Pascon EA, Langeland K.Traumatically injured primary incisors: a clinical and histological study[J]. ASDC J Dent Child, 1987, 54(6): 401-422.
[14] Andreasen JO, Ravn JJ.The effect of traumatic injuries to primary teeth on their permanent successors. Ⅱ. a clinical and radiographic follow-up study of 213 teeth[J]. Scand J Dent Res, 1971, 79(4): 284-294.
[15] Soares TRC, Silva LP, Salazar SLA, et al.Profile of intrusive luxation and healing complications in deciduous and permanent teeth - a retrospective study[J]. Acta Odontol Scand, 2018, 76(8): 567-571.
[16] Gondim JO, Moreira Neto JJ.Evaluation of intruded primary incisors[J]. Dent Traumatol, 2005, 21(3): 131-133.
[17] Gurunathan D, Murugan M, Somasundaram S.Management and sequelae of intruded anterior primary teeth: a systematic review[J]. Int J Clin Pediatr Dent, 2016, 9(3): 240-250.
[18] Flores MT.Traumatic injuries in the primary dentition[J]. Dent Traumatol,2002,18(6):287-298.
[19] Cunha RF, Pugliesi DM, Correa MG, et al.Early treatment of an intruded primary tooth: a case report[J]. J Clin Pediatr Dent, 2001, 25(3): 199-202.
[20] Shanmugam HV, Arangannal P, Vishnurekha C, et al.Management of intrusive luxation in the primary dentition by surgical repositioning: an alternative approach[J]. Aust Dent J, 2011, 56(2): 207-211.
[21] Trope M.Root resorption due to dental trauma[J]. Endod Topics, 2002, 1(1): 79-100.
[22] Diab M, elBadrawy HE. Intrusion injuries of primary incisors. Part Ⅱ: sequelae affecting the intruded primary incisors[J]. Quintessence Int, 2000, 31(5): 335-341.
[23] Trope M.Root resorption of dental and traumatic origin: classification based on etiology[J]. Pract Periodontics Aesthet Dent, 1998, 10(4): 515-522.
[24] Lauridsen E, Blanche P, Yousaf N, et al.The risk of healing complications in primary teeth with intrusive luxation: a retrospective cohort study[J]. Dent Traumatol, 2017, 33(5): 329-336.
[25] Innes NP.Traumatic intrusion of primary teeth and developmental defects in successor teeth[J]. Evid Based Dent, 2009, 10(3):70-71.
[26] de Amorim CS, Americano GCA, Moliterno LFM, et al. Frequency of crown and root dilaceration of permanent incisors after dental trauma to their predecessor teeth[J]. Dent Traumatol, 2018, 34(6): 401-405.
[27] Lenzi MM, da Silva Fidalgo TK, Luiz RR, et al. Trauma in primary teeth and its effect on the development of permanent successors: a controlled study[J]. Acta Odontol Scand, 2019, 77(1):76-81.
[28] Bardellini E, Amadori F, Pasini S, et al.Dental anomalies in permanent teeth after trauma in primary dentition[J]. J Clin Pediatr Dent, 2017, 41(1): 5-9.