The Journal of Korea Assosiation for Disability and Oral Health (대한장애인치과학회지)

Korean Association for Disability and Oral Health (대한장애인치과학회)
권호 표지
DOI QR코드

DOI QR Code

SURGICAL REPOSITIONING OF AN INTRUDED PERMANENT MAXILLARY INCISOR IN A CEREBRAL PALSY PATIENT: A CASE REPORT

뇌성마비 환자에서 함입된 상악 중절치의 외과적 재위치: 증례보고

  • Lee, Koeun (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Myeongyeon (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Jae-ho (Department of Pediatric Dentistry, College of Dentistry, Yonsei University)
  • 이고은 (연세대학교 치과대학 소아치과학교실) ;
  • 이명연 (연세대학교 치과대학 소아치과학교실) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실)
  • Received : 2017.06.02
  • Accepted : 2017.06.20
  • Published : 2017.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Patients with cerebral palsy have higher risk of traumatic dental injuries because of clinical characteristics, such as, ataxia, large overjet and lip incompetency. Especially, intrusive luxation has rare occurrence but higher incidence of complications. It can be treated by expecting re-eruption, orthodontic reposition, and surgical reposition. Clinicians should be aware of management and follow-up in dealing with cerebral palsy patients who are exposed by intrusive luxation, due to their involuntary movement. This case report describes a 9-year-old male patient with cerebral palsy and epilepsy who experienced intrusion of maxillary permanent central incisor. After one-month follow-up, waiting for spontaneous eruption, pulp necrosis on maxillary permanent central incisor had proceeded. Therefore, surgical reposition with resin wire splint and apexification was performed under conscious sedation with midazolam. After two months, removal of resin wire splint was done. Gutta percha filling and composite resin restoration were performed after sixteen months. During five-year follow-up ankylosis and partial root resorption were observed. But there was no significant complications.

본 증례는 함입 주소로 내원한 9세 4개월 뇌성마비 남환을 미다졸람 근주를 이용한 의식하 진정법으로 해당치아의 수술 적 재위치 및 근관치료를 시행하였다. 5년이 지난 현재 유착 소견 및 부분적인 치근흡수가 보이나 양호한 상태로 유지되고 있다. 뇌성마비 환자의 경우 치아 및 주위조직에 취약하며, 치료 시 적절한 행동조절 및 치료 방법을 선택하는 임상의의 노력이 필요하다.

Keywords

References

  1. Krigger KW : Cerebral palsy: an overview. Am Fam Physician, 73:91-100, 2006.
  2. Glendor U : Aetiology and risk factors related to traumatic dental injuries-a review of the literature. Dent Traumatol, 25:19-31, 2009. https://doi.org/10.1111/j.1600-9657.2008.00694.x
  3. Andreasen L, Andreasen FM, Andreasen JO : Textbook and color atlas of traumatic injuries to the teeth, Blackwell Publishing Ltd., UK, 428-431, 2007.
  4. Andreasen JO, Bakland LK, Andreasen FM : Traumatic intrusion of permanent teeth. Part 2. A clinical study of the effect of preinjury and injury factors, such as sex, age, stage of root development, tooth location, and extent of injury including number of intruded teeth on 140 intruded permanent teeth. Dent Traumatol, 22:90-98, 2006. https://doi.org/10.1111/j.1600-9657.2006.00422.x
  5. Andreasen J : A clinical and radiographic followup study of 189 injured teeth. Scand J Dent Res, 78:273-286, 1970.
  6. DiAngelis AJ, Andreasen JO, Ebeleseder KA, et al. : Guidelines for the Management of Traumatic Dental Injuries: 1. Fractures and Luxations of Permanent Teeth. Pediatr Dent, 38:358-368, 2016.
  7. Lalwani K, Kitchin J, Lax P : Office-based dental rehabilitation in children with special healthcare needs using a pediatric sedation service model. J Oral Maxillofac Surg, 65:427-433, 2007. https://doi.org/10.1016/j.joms.2005.12.057
  8. Rodrigues dos Santos MT, Masiero D, Novo NF, et al. : Oral conditions in children with cerebral palsy. J Dent Child, 70:40-46, 2003.
  9. Franklin DL, Luther F, Curzon ME : The prevalence of malocclusion in children with cerebral palsy. Eur J Orthod, 18:637-643, 1996. https://doi.org/10.1093/ejo/18.6.637
  10. Curl C, Boyle C : Sedation for patients with movement disorders. Dent Update, 39:45-48, 2012. https://doi.org/10.12968/denu.2012.39.1.45
  11. Tsilingaridis G, Malmgren B, Andreasen JO, et al. : Intrusive luxation of 60 permanent incisors: a retrospective study of treatment and outcome. Dent Traumatol, 28:416-422, 2012. https://doi.org/10.1111/j.1600-9657.2011.01088.x
  12. Albadri S, Zaitoun H, Kinirons MJ : UK National Clinical Guidelines in Paediatric Dentistry: treatment of traumatically intruded permanent incisor teeth in children. Int J Paediatr Dent, 1:1-2, 2010.
  13. Andreasen JO, Bakland LK, Andreasen FM : Traumatic intrusion of permanent teeth. Part 3. A clinical study of the effect of treatment variables such as treatment delay, method of repositioning, type of splint, length of splinting and antibiotics on 140 teeth. Dent Traumatol, 22:99-111, 2006. https://doi.org/10.1111/j.1600-9657.2006.00423.x
  14. Min B, Lee JH : Mitigation of maxillary anterior teeth protrusion with cerebral palsy using removable appliance: a case report. J Korean Dis Oral Health, 9:122-126, 2013.
  15. Ebeleseder KA, Santler G, Glockner K, et al. : An analysis of 58 traumatically intruded and surgically extruded permanent teeth. Endod Dent Traumatol, 16:34-39, 2000. https://doi.org/10.1034/j.1600-9657.2000.016001034.x
  16. Humphrey JM, Kenny DJ, Barrett EJ : Clinical outcomes for permanent incisor luxations in a pediatric population. I. Intrusions. Dent Traumatol, 19:266-273, 2003. https://doi.org/10.1034/j.1600-9657.2003.00207.x