Komplike bir travma olgusu ve tedavisi 22 aylık takip

Bu olgu bildirisinde; travma sonucu komplike diş ve destek doku yaralanması görülen çocuk hastanın tedavisinin ve klinik takiplerinin sunulması amaçlanmıştır. Karşılaştığı travma nedeniyle komplike bir şekilde yaralanan 10 yaşındaki bir erkek hasta 4 saat sonra kliniğimize başvurmuştur. Yapılan ağız içi ve dışı muayene sonucunda, 11-21 numaralı dişlerinde avülsion ve 14 numaralı dişinde ekstrüzyon ve lateral luksasyon, sağ dudak köşesinde ve kaşında yırtık olduğu tespit edilmiştir. Nemli ortamda kliniğimize ulaştırılan 11-21 numaralı dişler, soket steril salin solüsyonuyla temizlendikten sonra, lokal anestezi altında replante edilmiştir. 14 numaralı diş parmak basıncıyla yerleştirilip dişler 1. büyük azılara kadar ortodontik telle splintlenmiştir. 1 hafta sonra 11-21 numaralı dişlere kanal tedavisi başlanmış, 4. haftanın sonunda splint çıkarılmıştır. Kalsiyum hidroksit tedavisinin ardından dişlerin daimi kanal dolgusu guta-perka konlar ve AH Plusla yapılmış, dişler kompozit rezinle restore edilmiştir. Dişler 22 ay süreyle klinik ve radyografik olarak kontrol edilmiştir. Bu olguda, avülsiyon yaralanması sonrası replante edilen üst ön santral dişlerin tedavisinin başarılı olduğu ve kök gelişimi tamamlanmadan ekstrüze olan küçük azı dişinin, yeniden konumlandırıldığında kök gelişiminin devam ettiği ve takip süresi boyunca canlılığını koruduğu gözlenmiştir

A Comlicated Dental Trauma and Treament 22 months follow-up

The aim of this case report is to present the teratment and follow-up of a pediatric patient with complicated teeth and periodontal tissue injuries due to orofacial trauma. A 10 year-old male patient with a history of complicated trauma referred to our clinic 4 hours after the injury. Extraoral and intraoral exemination revealed avulsion of both left and right maxillary incisors, extrusion and lateral luxation of right maxillary first premolar with the rupture of right comissura and eyebrow. Prior the replantation, under local anesthesia the socket was gently cleaned and irrigated with saline solution, then the avulsed teeht were placed in position. After the repositioning of extrused premolar with finger pressure, teeth were splinted with orthodontic wire from maxillary first molar to right maxillary first molar. Root canal treatment were done one week later in both incisors, root canals were filled with gutta-percha points and AH Plus. 4 week later the splint was removed. The periodical exeminations were performed for 22 months. In this case report, replantation of avulsed central incisors teeth and repositioning of extruded premolar with incomplete root development were considered as successful, besides, the immature premolar tooth mainteined its vitality and its root formation proceeded during the follow-up period.

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