AVULSİYON SONRASI DİŞ KAYBI OLDUĞU OLGULARDA GÜNCEL TEDAVİ YAKLAŞIMLARI

Yıl 2020, Cilt: 47 Sayı: 1-3, 187 - 192, 31.12.2020

Betül Büşra Ursavaş , Tuğba Bezgin

Öz

Avulsiyon diş hekimliğinde nadir karşılaşılan acil durumlardan biridir. En iyi prognoz dişin hemen replante edildiği durumlarda gözlenir ancak bu sıklıkla mümkün olmaz. Replantasyonun başarısı travmanın üzerinden geçen süre, saklama ortamı gibi pek çok faktörden etkilenir. Uygun koşullar sağlanamadığında iyileşme ankiloz ya da inflamatuar rezorbsiyon şeklinde gerçekleşebilir. Erken dönemde ankiloz oluşumu alveolar kemiğin gelişimini de etkileyerek ilerleyici infraokluzyona sebep olabilir. Bu durumda, gelecekte implant uygulanması zorlaşabilir. Replante dişin inflamatuar rezorbsiyonu ise dişin kaybına neden olabilir. Genç hastalarda anterior bir dişin kaybı hem fizyolojik hem psikolojik sorunlar yaratır. Bu nedenle ankiloz durumunda kemik yüksekliğini korumak için dekoronasyon, diş kaybedildiğnde ise premolar bir dişin transplantasyonu ya da ortodontik mini implant destekli restorasyonların kullanımı gibi yeni tedavi seçenekleri önerilmiştir. Bu makalede bu yeni yöntemler derlenmiştir.

Anahtar Kelimeler

Ankiloz, Dekoronasyon, Dental avulsiyon, Mini implant, Premolar diş ototransplantasyonu, Replantasyon

Current Treatment Approaches in Cases of Dental Loss After Avulsion

Öz

Avulsion is one of the rare emergencies in dentistry. The best prognosis is observed when the tooth is replanted immediately, however this is not often possible. The success of replantation is affected by many factors such as extraoral time and the storage environment. When the appropriate conditions are not provided, healing can be in the form of ankylosis or inflammatory resorption. The formation of ankylosis in the early period may also affect the development of the alveolar bone and cause progressive infraocclusion. In this case, implant treatment may be difficult in the future. Inflammatory resorption of the replanted tooth may cause tooth loss. The loss of an anterior tooth in young patients cause both physiological and psychological problems. Therefore, new treatment options such as decoronation to maintain bone height in case of ankylosis, transplantation of a premolar tooth or the use of orthodontic mini implant-supported restorations have been proposed. These new methods have been compiled in this article.

Anahtar Kelimeler

Ankylosis, Decoronation, Dental avulsion, Mini implant, Premolar tooth ototranspantation, Replantation

Kaynakça

• 1. Fouad AF, Abbott PV, Tsilingaridis G, Cohenca N, Lauridsen E, Bourguignon C, et. al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol 2020; 36: 331-42.
• 2. Andreasen JO, Kristerson L. Evaluation of different types of autotransplanted connective tissues as potential periodontal ligament substitutes. An experimental replantation study in monkeys. Int J Oral Surg 1981;10:189–201.
• 3. Fuss Z, Tsesis I, Lin S. Root resorption--diagnosis, classification and treatment choices based on stimulation factors. Dent Traumatol 2003;19:175-82.
• 4. Kawanami M, Andreasen JO, Borum MK, Schou S, Hjorting-Hansen E, Kato H. Infraposition of ankylosed permanent maxillary incisors after replantation related to age and sex. Endod Dent Traumatol 1999;15:50-6
• 5. Finucane D, Kinirons MJ. External inflammatory and replacement resorption of luxated, and avulsed replanted permanent incisors: a review and case presentation. Dent Traumatol 2003;19:170-4
• 6. Malmgren B, Cvek M, Lundberg M, Frykholm A. Surgical treatment of ankylosed and infrapositioned reimplanted incisors in adolescents. Scand J Dent Res 1984:92:391-9.
• 7. Malmgren B, Malmgren O. Rate of infraposition of reimplanted ankylosed incisors related to age and growth in children and adolescents. Dent Traumatol 2002:18:28-36.
• 8. Campbell KM, Casas MJ, Kenny DJ, Chau T. Diagnosis of ankylosis in permanent incisors by expert ratings, Periotest and digital sound wave analysis. Dental Traumatol. 2005; 21: 206–12.
• 9. Kristerson L, Lagerström L. Autotransplantation of teeth in cases with agenesis or traumatic loss of maxillary incisors. Eur J Orthod. 1991; 13: 486–92.
• 10. Ebeleseder KA, Friehs S, Ruda C, Pertl C, Glockner K, Hulla H. A study of replanted permanent teeth in different age groups. Endod Dent Traumatol 1998; 14: 274–8.
• 11. Malmgren B, Malmgren O, Andreasen JO. Alveolar bone development aftre decoronation of ankylosed teeth. Endod Topics 2006; 14:35-40.
• 12. Malmgren, Barbro. Decoronation: how, why, and when. J Calif Dent Assoc 2000; 28: 846-54.
• 13. Cohenca N, Stabholz A. Decoronation-A conservative method to treat ankylosed teeth for preservation of alveolar ridge prior to permanent prosthetic reconstruction: literature review and case presentation. Dent Traumatol 2007; 23: 87-94.
• 14. Diaz JA, Almeida AM, Benavente AA. Tooth transplantation after dental injury sequelae in children. Dent Traumatol 2008; 24: 320-7.
• 15. Andreasen JO. Periodontal healing after replantation and autotransplantation of incisors in monkeys. Int J Oral Surg 1981;10:54-61.
• 16. Andreasen JO, Paulsen HU, Yu Z, Ahlquist R, Bayer T, Schwartz O. A long-term study of 370 autotransplanted premolars Part I Surgical procedures and standardized techniques for monitoring healing. Eur J Orthod 1990;12:3-13.
• 17. Waldon K, Barber SK, Spencer RJ, Duggal MS. Indications for the use of auto-transplantation of teeth in the child and adolescent. Eur Arch Paediatr Dent, 2012, 13: 210-6.
• 18. Day PF, Lewis BRK, Spencer RJ, Barber SK, Duggal MS. The design and development of surgical templates for premolar transplants in adolescents. Int Endod J 2012; 45: 1042-52.
• 19. Vishwanath M, Janakiraman N, Vaziri H, Nanda R, Uribe F. Autotransplantation: A biological treatment alternative for a patient after traumatic dental injury. Korean J Orthod 2018; 48: 125-30.
• 20. Day PF, Duggal MS. Autotransplantation for failing and missing anterior teeth. Pediatr Dent 2008; 30: 286-8.
• 21. De Oliveria NS, de Rezende Barbosa GL, Lanza LD, Pretti H. Prosthetic rehabilitation of child victim of avulsion of anterior teeth with orthodontic mini-implant. Case Rep Dent 2017; 2017:8905965.
• 22. Giannetti L, Diago AMD, Vecci F, Consolo U. Mini-implants in growing patients: A case report. Pediatr Dent 2010; 32: 239-44.
• 23. Nuvulla S, Mohapatra A, Kiranmayi M, Rekhalakshmi K. Anterior fixed interim prosthesis with natural tooth crown as pontic subsequent to replantation failure. J Conserv Dent 2011; 14: 432-5.
• 24. Aydın MY, Kargül B. Glass-fiber reinforced composite in management of avulsed central incisor: A case report. J Dent Child 2004; 7: 66-8.