   Drs. Ruviére and Costa are post doctoral    students, and Dr. Cunha is adjunct professor, all in    the Department of ...
   INTRUSION    Apical displacement of tooth into the    alveolar bone. The tooth is driven into    the socket, compressi...
 Dental traumatic injuries in infants and  young children are common. Retrospective and prospective studies  related tha...
 color change, pulp necrosis, obliteration of the pulp canal, gingival retraction, primary tooth displacement, patho...
 tooth displacement within the socket  and can affect the crown, root, or entire  permanent tooth germ. anomalous devel...
   The aim of diagnosis and treatment of    traumatic injuries in primary teeth is to    manage pain and prevent sequelae...
   If the apex is displaced toward or    through the labial bone plate, the tooth    is left for spontaneous re-eruption....
   To describe the treatment of a primary    maxillary right lateral incisor in which    spontaneous re-eruption after se...
   The research protocol was submitted for    review to the Ethics in Human Research    Committee of the School of Dentis...
   The extraoral examination revealed a mild    edema and several small cuts and    lacerations on the maxillary and    m...
3 days after suffering dental trauma
3 days after suffering dental trauma
   The primary maxillary right lateral incisor’s    apex was dislocated into the    vestibule, indicating a labial    dis...
 After 30 days, although the tooth had  not initiated the re-eruption  process, clinical examination showed a  normal asp...
   Sixty days following the dental trauma,    the beginning of spontaneous re-    eruption of the primary maxillary right...
4 months after dental trauma
   Twelve months after the trauma,    radiograph evaluations showed that the    root resorption was stabilized and clinic...
18 months after dental trauma
after 4 years
after 4 years
   The parents were informed of the    sequelae of the primary intruded tooth’s    condition and morphological alteration...
   If the apex is dis-placed labially, the    apical tip can be seen radiographically    with the tooth appearing shorter...
   to allow spontaneous re-eruption except    when displaced into the developing    successor
 to reposition passively, actively or surgicallyand then to stabilize the tooth with a splint  for up to 4 weeks
   For immature the objective is to allow for    spontaneous eruption   In mature teeth, the goal is to reposition    th...
   The preference for intrusion into the    permanent maxillary central and lateral    incisor appears to be related to t...
 Depending on the vestibular curvature  of the primary teeth’s root and the  impact’s direction, the apexes of these  tee...
 timing of seeking care the family’s eagerness to maintain the  teeth, and the patient’s age
   Gondim et al, who evaluated 22 intruded    teeth and showed a total re-eruption in    43% of cases, partial re-eruptio...
   In a follow-up study of 123 intruded    primary incisors, total re-eruption    occurred in 84% of the completely    in...
   In addition, in a clinical study of 123    intruded teeth available for follow-up    evaluation, 88% re-erupted fully,...
   In a study of 11 cases of primary intruded    tooth Seven cases have been observed    satisfactory without surgical tr...
   Diab et al described that when the tooth    was intruded completely, the tooth    should be extracted because re-    e...
    Several studies support that the    permanent tooth germ’s malformation    may be the result of severe intrusion by  ...
 The type of traumatic primary tooth injury  combined with the child’s age at the  time of the injury can indicate the  p...
 In this case report, secondary damage  on the permanent maxillary right central  and lateral incisors’ germs was observe...
 Ruviére, Costa, Cunha. Conservative Management of Severe  Intrusion in a Primary Tooth: A 4-year Follow-up. J Dent Child...
New microsoft office power point presentation
New microsoft office power point presentation
New microsoft office power point presentation
Upcoming SlideShare
Loading in …5
×

New microsoft office power point presentation

615 views

Published on

Published in: Health & Medicine, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
615
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
12
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

New microsoft office power point presentation

  1. 1.  Drs. Ruviére and Costa are post doctoral students, and Dr. Cunha is adjunct professor, all in the Department of Pediatric and Social Dentistry, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil. Correspond with Dr. Cunha at cunha@foa.unesp.br J Dent Child 2009;76:87-91
  2. 2.  INTRUSION Apical displacement of tooth into the alveolar bone. The tooth is driven into the socket, compressing the periodontal ligament and commonly causes a crushing fracture of the alveolar socket
  3. 3.  Dental traumatic injuries in infants and young children are common. Retrospective and prospective studies related that prevalence of these injuries involving the primary dentition ranged from 4% to 33%.
  4. 4.  color change, pulp necrosis, obliteration of the pulp canal, gingival retraction, primary tooth displacement, pathological root resorption, and premature loss of the primary tooth.
  5. 5.  tooth displacement within the socket and can affect the crown, root, or entire permanent tooth germ. anomalous development of the permanent teeth, with a frequency between 18% and 69%.
  6. 6.  The aim of diagnosis and treatment of traumatic injuries in primary teeth is to manage pain and prevent sequelae for the developing permanent tooth germ
  7. 7.  If the apex is displaced toward or through the labial bone plate, the tooth is left for spontaneous re-eruption. If the apex is displaced toward the permanent tooth germ, the tooth should be extracted.
  8. 8.  To describe the treatment of a primary maxillary right lateral incisor in which spontaneous re-eruption after severe traumatic intrusion occurred and its possible consequences on the developing successive permanent germs.
  9. 9.  The research protocol was submitted for review to the Ethics in Human Research Committee of the School of Dentistry of Araçatuba, São Paulo State University, Araçatuba, São Paulo, Brazil, and the case report design was approved. 18-month-old male
  10. 10.  The extraoral examination revealed a mild edema and several small cuts and lacerations on the maxillary and mandibular lips. The intraoral examination revealed complete intrusion of the primary maxillary right lateral incisor, crown fracture of the primary maxillary right central incisor without pulp involvement, and disruption of the superior labial frenum, with no pain related.
  11. 11. 3 days after suffering dental trauma
  12. 12. 3 days after suffering dental trauma
  13. 13.  The primary maxillary right lateral incisor’s apex was dislocated into the vestibule, indicating a labial displacement direction
  14. 14.  After 30 days, although the tooth had not initiated the re-eruption process, clinical examination showed a normal aspect, characterized by no dental crown discoloration, mobility, or pain. Radiographic examination also revealed normal aspects
  15. 15.  Sixty days following the dental trauma, the beginning of spontaneous re- eruption of the primary maxillary right lateral incisor was observed clinically.
  16. 16. 4 months after dental trauma
  17. 17.  Twelve months after the trauma, radiograph evaluations showed that the root resorption was stabilized and clinical findings revealed no pain, discoloration, or mobility of the dental crown. The endodontic intervention was not performed.
  18. 18. 18 months after dental trauma
  19. 19. after 4 years
  20. 20. after 4 years
  21. 21.  The parents were informed of the sequelae of the primary intruded tooth’s condition and morphological alterations in the permanents teeth.
  22. 22.  If the apex is dis-placed labially, the apical tip can be seen radiographically with the tooth appearing shorter than its contralateral If the apex is displaced palatally towards the permanent tooth germ, the apical tip cannot be seen radiographically and the tooth appears elongated.
  23. 23.  to allow spontaneous re-eruption except when displaced into the developing successor
  24. 24.  to reposition passively, actively or surgicallyand then to stabilize the tooth with a splint for up to 4 weeks
  25. 25.  For immature the objective is to allow for spontaneous eruption In mature teeth, the goal is to reposition the tooth with orthodontic or surgical extrusion and initiate endodontic treatment within the first 3 weeks of the traumatic incidence
  26. 26.  The preference for intrusion into the permanent maxillary central and lateral incisor appears to be related to the common fall direction in which these teeth are generally the first to make contact with extraoral objects.
  27. 27.  Depending on the vestibular curvature of the primary teeth’s root and the impact’s direction, the apexes of these teeth are usually dislocated into the vestibular. The most common initial treatment for traumatically intruded primary teeth is to wait for spontaneous re-eruption.
  28. 28.  timing of seeking care the family’s eagerness to maintain the teeth, and the patient’s age
  29. 29.  Gondim et al, who evaluated 22 intruded teeth and showed a total re-eruption in 43% of cases, partial re-eruption in 47% of cases, and no re-eruption in 11% of cases.Gondim JO, Moreira Neto JJS. Evaluation of intruded primary incisors. Dent Traumatol 2005;21:131-3.
  30. 30.  In a follow-up study of 123 intruded primary incisors, total re-eruption occurred in 84% of the completely intruded teeth and in 92% of those who had suffered partial intrusion.Borssén E, Holm A-K. Treatment of traumatic dental injuries in a cohort of 16-year- olds in northern Sweden. Endod Dent Traumatol 2000;16:276-81.
  31. 31.  In addition, in a clinical study of 123 intruded teeth available for follow-up evaluation, 88% re-erupted fully, 10% did not return to the occlusal plane, and 2% failed to re-erupt due to ankylosis Holan G, Ram D. Sequelae and prognosis of intruded primary incisors: A retrospective study. Pediatr Dent 1999;21:242-7.
  32. 32.  In a study of 11 cases of primary intruded tooth Seven cases have been observed satisfactory without surgical treatments such as re-positioning and fixation, and all those re- erupted to the occlusal level of the contra- lateral side within 1.5 year. Otherwise, 4 cases treated with re-positioning and fixation revealed periapical periodontitis in radiographic feature, alveolar abscess formation, or discoloration. Hirata et al. Management of Trauma of Primary Tooth: Report of Intrusion Case. J.Hard Tissue Biology 2005;14(4):361-362.
  33. 33.  Diab et al described that when the tooth was intruded completely, the tooth should be extracted because re- eruption could not be expected. On the other hand, Holan et al reported 108 of 123 intruded teeth were re-erupted spontaneously. Diab M. and Elbadrawy H.E.: Intrusion injuries of primary incisors. Part : Review and Management. Quintessennce Int 31:327-334, 2000
  34. 34.  Several studies support that the permanent tooth germ’s malformation may be the result of severe intrusion by the primary tooth and invasion of the developing germ during the earliest phases of odontogenesis, when the child is between 1 and 3 years old
  35. 35.  The type of traumatic primary tooth injury combined with the child’s age at the time of the injury can indicate the probability of subsequent damages to the primary tooth or permanent tooth germ involved. The importance of regular follow-ups should be emphasized to evaluate healing, oral hygiene, infection control, and evolution of the case
  36. 36.  In this case report, secondary damage on the permanent maxillary right central and lateral incisors’ germs was observed radiographically. The extent and type of actual damage was not definitively established.
  37. 37.  Ruviére, Costa, Cunha. Conservative Management of Severe Intrusion in a Primary Tooth: A 4-year Follow-up. J Dent Child 2009;76:87-91. Guideline on Management of Acute Dental Trauma. AAPD 201;33(6): 220-28. Gondim JO, Moreira Neto JJS. Evaluation of intruded primary incisors. Dent Traumatol 2005;21:131-3. Borssén E, Holm A-K. Treatment of traumatic dental injuries in a cohort of 16-year-olds in northern Sweden. Endod Dent Traumatol 2000;16:276-81. Holan G, Ram D. Sequelae and prognosis of intruded primary incisors: A retrospective study. Pediatr Dent 1999;21:242-7. Diab M. and Elbadrawy H.E.: Intrusion injuries of primary incisors. Part : Review and Management. Quintessennce Int 2000;31:327-334. Hirata et al. Management of Trauma of Primary Tooth: Report of Intrusion Case. J.Hard Tissue Biology 2005;14(4):361-362.

×