A Case of Intrusion With Mesiodens: 30 Months Follow Up A Case Report

Abstract

Intrusive luxation is a dental injury that causes damage to supporting structures and pulp of a tooth because of its dislocation into the alveolar bone. Mesiodens is the most common type of supernumerary tooth found in anterior maxilla. This report presents the case of a intruded immature permanent incisor and the treatment of a inverted mesiodens. A 7-year-old boy was referred to the clinic 1 day after trauma. After clinical and radiographic examinations, intrusive luxation of the immature left permanent incisor and a inverted mesiodens diagnosed between the roots of central incisors. The surgical removal of mesiodens was delayed in order not to interfere the reeruption of intruded incisor. The intrudedincisor, with careful monitoring, were allowed to spontaneously re-erupt, tooth started to re-erupt spontaneously in a few months. No periapical and/or pulpal pathology was observed during following period, root development continued, pulp remained vital. It can be concluded that intruded immature permanent teeth can spontaneously re-erupt, conserve their vitality, and continue their root development without any surgical or orthodontic management. However, with respect to surgical removal of mesiodens, ideal timing of intervention – immediate or delayed intervention – remains to be a highly controversial issue

Keywords

• intrusion, trauma, mesiodens

Mesiodens ile birlikte görülen bir intrüzyon olgusu: 30 aylık takip vaka sunumu

Abstract

İntrüziv lüksasyon, dişin alveoler kemik içerisine gömülmesi nedeniyle dişin destek yapıları ve pulpasında hasara yol açan bir travma tipidir. Mesiodens üst çene ön bölgede bulunan süpernümerer dişlerin en sık görülen tipidir. Bu rapor, intrüze immatür orta kesici dişin ve ters pozisyondaki mesiodensin tedavisini sunmaktadır. 7 yaşındaki erkek çocuk, travmadan 1 gün sonra kliniğimize başvurmuştur. Klinik ve radyografik muayeneler sonrasında, immatür sol orta kesici dişte intrüziv lüksasyon ve orta kesici dişler arasında inverte bir mesiodens teşhis edilmiştir. Mesiodensin cerrahi olarak çıkarılması, intrüze keser dişin yeniden sürmesini engellememek için ertelenmiştir. İntrüze keser diş dikkatle izlenerek kendiliğinden sürmesine izin verilmiş, diş birkaç ay içinde yeniden sürmeye başlamıştır. Takip süresi boyunca pulpal ve/veya periapikal patoloji görülmemiş, kök gelişimi devam etmiş, pulpa canlı kalmıştır. İntrüze immatür daimi dişlerin herhangi bir cerrahi ya da ortodontik müdahaleye gerek kalmadan canlılıklarını koruyup kendiliğinden sürdükleri sonucuna varılabilir. Ancak, mesiodensin cerrahi olarak çıkarılması, ideal müdahale zamanlaması açısından-erken ya da geç müdahale-son derece tartışmalı bir konu olmaya devam etmektedir.

Keywords

• intrüzyon, travma, mesiodens

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