Ağız İçine Avülse Olan Mandibular Anterior Dişlerde Tedavi ve Takip: Bir Vaka Raporu

Yıl 2025, Cilt: 3 Sayı: 1, 187 - 194, 28.04.2025

Bilal Özmen , Burcu Yılmaz , Şeyma Çolak

Öz

Bu vaka raporunun amacı ağız içine avülse olan alt çene 4 kesici dişin tedavi ve prognozun sunulmadır. 10 yaşında erkek hasta okul bahçesinde düşme sonucu alt çene dört kesici dişinin ağız içine avülse olması şikayetiyle ağız diş sağlığı merkezine başvurmuş orada herhangi bir müdahale yapılmaksızın pedodonti kliniğimize yönlendirilmiştir. Yapılan muayenede avülse dişlerin dil üzerinde yumuşak dokuya bağlı şekilde durmuş olduğu gözlenmiştir. Avülsiyon bölgesine lokal anestezi uygulayarak dişler reimplante edilmiş semi-rijit splint ile splintlenmiştir. Alveol kemikte bulunan hasardan dolayı splint süresi 4 hafta olarak belirlenmiştir. Kanal tedavisine travmadan 10 gün sonra başlanmıştır. Splint 4 hafta sonunda çıkarılmış ve kanal tedavisi güta perka ile doldurularak tamamlanmıştır. Hasta takipleri devam etmektedir. Avülse olan dişler her ne kadar ağız içinde bulunsa da soket dışında bulunduğu için periodontal ligament ve pulpa canlılığını yitirir. Bu sebeple avülse olan dişlerin nekroz olmuş pulpa dokusunun çıkaralıp güta perka ile doldurulması gerekir.

Anahtar Kelimeler

Avülsiyon , splint , reimplantasyon

Treatment and Follow-up of Mandibular Anterior Teeth Avulsed Into the Mouth: A Case Report

Öz

The aim of this case report is to present the treatment and prognosis of the mandibular 4 incisors that avulsed into the mouth. A 10-year-old male patient applied to the oral and dental health center with the complaint of avulsion of the four incisors of the mandibular into the mouth as a result of a fall in the schoolyard. He was referred to our pedodontics clinic without any intervention. During the examination, it was observed that the avulsed teeth were attached to the soft tissue on the tongue. By applying local anesthesia to the avulsion area, the teeth were reimplanted and splinted with a semi-rigid splint. Due to the damage to the alveolar bone, the splint duration was determined as 4 weeks. Root canal treatment was started 10 days after the trauma. The splint was removed after 4 weeks and the root canal treatment was completed by filling it with gutta percha. Patient follow-up continues. Even though the avulsed teeth are in the mouth, the periodontal ligament and pulp lose their vitality because they are outside the socket. For this reason, the necrosed pulp tissue of avulsed teeth must be removed and filled with gutta percha.

Anahtar Kelimeler

Avulsion , splint , reimplantation

Kaynakça

• 1. Veras SRD, Bem JSP, Dealmeida ECB, Dos Santos CC, Lins A. Dental splints: types and time of immobilization post tooth avulsion. European Oral Research. 2017;51(3).
• 2. Finucane D, Kinirons MJ. External inflammatory and replacement resorption of luxated, and avulsed replanted permanent incisors: a review and case presentation. Dental Traumatology. 2003;19(3):170-4.
• 3. Singh M, Singh N, Dhiman RK, Kumar D. External replacement resorption in an avulsed reimplanted permanent incisors. Journal of the International Clinical Dental Research Organization. 2013;5(1):27-30.
• 4. von Arx T, Chappuis V, Hänni S. Verletzungen der bleibenden Zähne, Teil 2: Therapie der Dislokationsverletzungen. Schweiz Monatsschr Zahnmed. 2005;115(11):1057-67.
• 5. Raphael SL, Gregory PJ. Parental awareness of the emergency management of avulsed teeth in children. Australian Dental Journal. 1990;35(2):130-3.
• 6. El Kharroubi S, Drouri S, Doumari B, Dhoum S, El Merini H. Management of 3 Avulsed Permanent Teeth: Case Report of a 3‐Year Follow‐up. Case Reports in Dentistry. 2022;2022(1):2081684.
• 7. Bourguignon C, Lenzi AR, Tsukiboshi M, Andersson L, Lamar Hicks M, Malmgren B, et al. Guidelines for the Management of Traumatic Dental Injuries: 2. Avulsion of Permanent Teeth. Pediatric Dentistry. 2013;35(6).
• 8. Parthasarathy R, Srinivasan S, Vikram C, Thanikachalam Y, Ramachandran A. An interdisciplinary management of avulsed maxillary incisors: A case report. Cureus. 2022;14(4).
• 9. Longo DL, Fumes AC, Küchler EC, Paula‐Silva FW, Nelson‐Filho P, Silva LA. Efficiency of different storage media for avulsed teeth in animal models: a systematic review. Dental Traumatology. 2018;34(1):12-9.
• 10. Kahler B, Hu JY, Marriot‐Smith C, Heithersay G. Splinting of teeth following trauma: a review and a new splinting recommendation. Australian dental journal. 2016;61:59-73.
• 11. 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. Dental traumatology. 2020;36(4):331-42.
• 12. Poi WR, Sonoda CK, Martins CM, Melo ME, Pellizzer EP, Mendonça MRd, et al. Storage media for avulsed teeth: a literature review. Brazilian dental journal. 2013;24(5):437-45.
• 13. Khademi A, Saei S, Mohajeri M, Mirkheshti N, Ghassami F. Torabi nia N, Alavi SA. A new storage medium for an avulsed tooth. J Contemp Dent Pract. 2008;9(6):25-32.
• 14. Udoye CI, Jafarzadeh H, Abbott PV. Transport media for avulsed teeth: a review. Australian Endodontic Journal. 2012;38(3):129-36.
• 15. Malhotra N. Current developments in interim transport (storage) media in dentistry: an update. British dental journal. 2011;211(1):29-33.
• 16. DOĞAN MC. Güncel Pedodonti Çalışmaları: Akademisyen Kitabevi; 2020.
• 17. Albertsson J, Lauridsen E, Andreasen JO, Gerds TA, Andersson L. The risks of ankylosis of 89 avulsed human teeth stored in saliva prior to replantation—A re‐evaluation of a long‐term clinical study. Dental Traumatology. 2021;37(4):537-45.
• 18. Wang G, Wang C, Qin M. A retrospective study of survival of 196 replanted permanent teeth in children. Dental Traumatology. 2019;35(4-5):251-8.
• 19. Andreasen J, Borum MK, Jacobsen H, Andreasen F. Replantation of 400 avulsed permanent incisors. 4. Factors related to periodontal ligament healing. Dental traumatology. 1995;11(2):76-89.
• 20. Andreasen J. Effect of extra-alveolar period and storage media upon periodontal and pulpal healing after replantation of mature permanent incisors in monkeys. International Journal of Oral Surgery. 1981;10(1):43-53.
• 21. Panzarini SR, Gulinelli JL, Poi WR, Sonoda CK, Pedrini D, Brandini DA. Treatment of root surface in delayed tooth replantation: a review of literature. Dental Traumatology. 2008;24(3):277-82.
• 22. Kabra SP, Deshkar M, Thosar NR, Khubchandani M. Successful Replantation of an Anterior Tooth in an 11-Year-Old Child: A Case Report. Cureus. 2024;16(7).
• 23. Kadulkar N, Kataki R, Deka A, Thonai S. Replantation of an Avulsed Tooth: A Case Report. Cureus. 2023;15(5).
• 24. Al-Kahtani A. Avulsed immature permanent central incisors obturated with mineral trioxide aggregate: a case report. Journal of International Oral Health: JIOH. 2013;5(3):88.
• 25. Vogt BF, Souza CECP, Silva DN, Etges A, Campos MM. Evaluation of two formulations containing mineral trioxide aggregate on delayed tooth replantation: relevance of RANKL/RANK/OPG system. Odontology. 2016;104:211-9.
• 26. Guedes de Amorim LdF, Resende Sucasas da Costa LR, Estrela C. Retrospective study of traumatic dental injuries in primary teeth in a Brazilian specialized pediatric practice. DENTAL TRAUMATOLOGY. 2011;27(5):368-73.
• 27. Holan G. Development of clinical and radiographic signs associated with dark discolored primary incisors following traumatic injuries: a prospective controlled study. Dental Traumatology. 2004;20(5):276-87.
• 28. Luther M, Gardiner FW, Bishop L. Management of Traumatic Tooth Avulsion Using 2-Octyl Cyanoacrylate Tissue Adhesive Splint: A Case Report. Journal of Emergency Nursing. 2020;46(5):693-7.
• 29. Cubukcu CE, Suer BT, Sonmez SC. A rare dental avulsion case report highlighting the importance of rapid replantation for long-term survival. Ulus Travma Acil Cerrahi Derg. 2024;30(12):914-7.
• 30. Andreasen JO, Andreasen FM, Andersson L. Textbook and color atlas of traumatic injuries to the teeth: John Wiley & Sons; 2018.