Management of chronic luxated central incisor with hopeless prognosis
Journal name: Journal of Indian Society of Periodontology
Original article title: Management of chronic luxated central incisor with hopeless prognosis
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:
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Gauresh Kumar Patel, Sheela Kumar Gujjari, B. M. Annapoorna, S. C. Veerendra Kumar
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Management of chronic luxated central incisor with hopeless prognosis
Year: 2013 | Doi: 10.4103/0972-124X.119292
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Traumatic dental injuries, particularly luxation injuries, pose significant challenges for dental practitioners. Extrusive luxation, where a tooth is partially displaced from its socket, requires immediate repositioning and careful monitoring of pulp sensibility. If these injuries become chronic, management becomes considerably more complex, especially when the tooth is necrotic and periodontal support is compromised. Intentional replantation has emerged as a viable treatment option for such cases, incorporating innovative techniques such as the use of platelet-rich fibrin (PRF) to enhance healing and periodontal regeneration.
Role of Platelet-Rich Fibrin in Intentional Replantation
Platelet-rich fibrin (PRF) is a second-generation growth factor developed for its regenerative properties in dental and surgical procedures. PRF, obtained through the centrifugation of blood, creates a fibrin matrix rich in platelets, leukocytes, and cytokines, which together facilitate effective tissue regeneration through enhanced cell migration, proliferation, and sustained release of growth factors. In the presented case of a 16-year-old boy with an extrusively luxated central incisor, PRF was utilized alongside intentional replantation after endodontic treatment. The incorporation of PRF with nano hydroxyapatite crystals aimed to promote periodontal healing and bone regeneration in the tooth's socket. The treatment protocol allowed for improved clinical outcomes, including reduced probing pocket depth and notable bone gain, demonstrating the potential effectiveness of combining PRF in engaging reconstructive dental procedures.
Conclusion
The successful management of extrusive luxation injuries through intentional replantation with PRF presents a promising treatment avenue, particularly for patients unable to afford more conventional options like implants. This strategy not only conservatively retains the natural tooth but also enhances healing outcomes and functionality. As illustrated in this case, using PRF significantly improved the prognosis of a tooth with a hopeless outcome, indicating the necessity for further studies and long-term follow-ups to establish its efficacy as a standard treatment protocol in similar dental cases. The results suggest that PRF can play a crucial role in enhancing therapeutic outcomes for periodontally compromised teeth, underpinning the importance of innovation in dental trauma management.
FAQ section (important questions/answers):
What is extrusive luxation and its management approach?
Extrusive luxation is a dental injury where a tooth is displaced out of its socket. Immediate repositioning and splinting of the tooth are essential. Periodic evaluation of pulp sensibility is conducted to monitor tooth viability.
What entails intentional replantation in dental treatment?
Intentional replantation involves the deliberate extraction of a tooth followed by its reinsertion into the socket, often after endodontic treatment. It is considered when other restorative options are not viable and aims to preserve the natural tooth.
What role does platelet rich fibrin (PRF) play in this case?
PRF serves as a biological scaffold that promotes healing and tissue regeneration. It releases growth factors essential for periodontal healing, enhancing the success of intentional replantation by supporting cellular migration and proliferation.
What were the patient's treatment options following the traumatic injury?
The patient could have opted for removable partial dentures, fixed partial dentures, or implants. However, due to financial constraints and a desire to retain the natural tooth, intentional replantation was chosen as the treatment option.
What were the outcomes of using PRF in this dental case?
The use of PRF during intentional replantation resulted in significant bone gain, reduced probing pocket depth, and improved stability of the tooth over the follow-up period, demonstrating its effectiveness in managing periodontal issues.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Management of chronic luxated central incisor with hopeless prognosis�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Composite:
Composite refers to a type of dental material made from a mixture of resin and filler particles. It is commonly used for restorative procedures to improve the esthetics of teeth, as it can mimic the natural appearance of tooth structure. In this case, composite buildup was employed to restore fractured teeth, achieving both functional and visual goals.
2) Rich (Ṛch):
Rich, in the context of platelet-rich fibrin (PRF), refers to a high concentration of platelets and growth factors essential for tissue regeneration. The richness of this fibrin matrix plays a significant role in promoting healing, cell proliferation, and effective wound closure following intentional replantation of the tooth.
3) Post:
Post, in this context, refers to a post-placement procedure involving the insertion of a dental post into the root canal of a tooth prior to the restorative phase. It provides structural support for the composite buildup and helps anchor the restoration in place, especially after significant tooth structure loss.
4) Blood:
Blood is a vital biological fluid containing red and white blood cells, plasma, and platelets. In dental procedures, blood is drawn and processed to create platelet-rich fibrin (PRF), which is utilized to enhance healing and regeneration of periodontal tissues after the intentional replantation of teeth.
5) Knowledge:
Knowledge denotes the understanding and information necessary to make informed decisions regarding dental treatments. In the case discussed, dental practitioners relied on their knowledge of dental trauma management and experience with innovative techniques, like PRF, to provide effective and conservative treatment for the young patient.
6) Surface:
Surface refers to the outer layer of a tooth, which can be prepared or treated to enhance healing and integration during dental procedures. In intentional replantation cases, the root surface is treated using solutions like tetracycline or sodium fluoride to enhance the healing environment and reduce complications like resorption.
7) Repair:
Repair refers to the process of restoring damaged tissues to achieve functional integrity and aesthetic quality. In the discussed case, deliberate efforts were made to repair the periodontal structure around the replanted tooth using PRF and nano hydroxyapatite, promoting periodontal regeneration and overall tooth stabilization.
8) Young boy:
Young boy signifies the age and developmental stage of the patient involved in this dental trauma case. Being a minor affected treatment decisions, emphasizing a conservative approach such as intentional replantation rather than more invasive options, due to both financial constraints and the importance of preserving natural dentition.
9) Antibiotic (Antibacterial):
Antibacterial refers to substances that destroy or inhibit the growth of bacteria. Tetracycline was used in this case as an antibacterial solution for the replanted tooth, aiding in the prevention of infection and inflammation while promoting a conducive environment for healing during the recovery period following the procedure.
10) Transformation (Transform, Transforming):
Transforming in this context relates to transforming growth factor-beta (TGF-β), a critical signaling protein involved in various cellular processes, including healing and tissue regeneration. The presence of TGF-β in PRF can enhance the regenerative process by stimulating cell proliferation and modulating the repair matrix during the healing phase.
11) Arrangement:
Arrangement refers to the planning or strategic positioning of dental treatment measures. In this case, it pertains to the critical alignment and positioning of the reimplanted tooth within its socket, which was deemed essential to restore occlusion and prevent future complications associated with improper placement.
12) Dressing:
Dressing signifies a protective covering applied to a wound or surgical site. After the intentional replantation procedure, a dressing might be placed to provide an optimal healing environment, prevent bacterial contamination, and support the newly positioned tooth until the healing process and integration are well established.
13) Grafting:
Grafting refers to the procedure of transplanting tissue to promote healing and regeneration. In the case discussed, the combination of PRF with hydroxyapatite can be viewed as a grafting technique, as it serves to fill in defects and encourage new bone growth in the compromised periodontal environment following replantation.
14) Hygiene (Hygienic):
Hygiene emphasizes the importance of maintaining oral cleanliness to prevent infections after dental procedures. In this case, hygiene instructions were given to the patient to foster a safe healing environment post-replantation, so as to avoid complications such as periodontal disease or implant failure initially.
15) Nature:
Nature encapsulates the inherent characteristics of biological systems and materials used in dental treatments. In the context of this case, the natural properties of PRF and the growth factors released enhance healing, demonstrating how understanding the nature of biological processes can lead to improved dental treatment outcomes.
16) Animal:
Animal denotes the use of animal studies to understand certain biological responses. In this dental context, animal-based research contributes to the knowledge of outcomes in procedures like intentional replantation, where findings help predict and optimize the success and postoperative results for similar human cases.
17) Glass:
Glass, particularly referring to bioactive glass, is a biocompatible material used in dental applications for bone regeneration. Its properties allow for interactions with biological tissues, promoting healing. While not mentioned directly in the case, the principles of bioactive materials represent a broader consideration in regenerative dentistry.
18) Visit:
Visit indicates a scheduled appointment where follow-up evaluations occur to monitor healing and dental health. In this case, regular visits were recommended to assess the success of the intentional replantation procedure, ensuring that healing is proceeding as planned, while allowing adjustments as needed.
19) Fight:
Fight pertains to the context of traumatic dental injuries often sustained in physical altercations or accidents. Such incidents are common causes of luxation injuries in young patients. Understanding the circumstances leading to dental trauma aids practitioners in designing targeted prevention and treatment strategies for affected individuals.
20) Beta (BÄ“á¹a, Beá¹a):
Beta in this case refers to transforming growth factor-beta (TGF-β), which is an important cytokine involved in tissue repair and regeneration. Its presence in regenerative scaffolds like PRF is essential for promoting healing and cellular activities, thus enhancing the outcomes of dental procedures involving replantation.
Other Science Concepts:
Discover the significance of concepts within the article: �Management of chronic luxated central incisor with hopeless prognosis�. Further sources in the context of Science might help you critically compare this page with similair documents:
Rehabilitation, Treatment modalities, Interdisciplinary approach, Wound healing, Clinical evaluation, Endodontic treatment, Financial constraint, Traumatic injuries, Healing Period, Clinical outcome, Bone loss, Growth factor, Platelet-rich-fibrin, Growing Age.