Ingeborg Jacobsen

Follow-up examination of endodontic treatment in traumatized juvenile incisors

The results of endodontic treatment in 166 traumatized incisors of 9- to 18-year-old patients were related to root development, age, type of injury, pulp status, periradicular status, and quality of the seal of the root filling. The patients were separated into two groups. In the first group, Ingles standardized preparation and obturation technique was modified, and root apexification was induced with calcium hydroxide before the canal obturation. The results showed that the original standardized technique was the preferred treatment of 13- to 18-year-old patients. For treatment of 9- to 12-year-old patients, however, the apexification treatment and the modified obturation technique were more successful.

Intrusive luxation of permanent incisors in Norwegians aged 6-17 years: a retrospective study of treatment and outcome.

BACKGROUND/AIM External replacement resorption (ankylosis-related) is a severe complication leading eventually to tooth loss. Little information exists regarding the influence of variables such as degree of intrusion or treatment method on the development of replacement resolution in intruded permanent incisors. The aim of this study was to report the most frequently involved age group, the preferred type of treatment, and the type and frequency of healing complications. Special attention was paid to the effect of treatment on the occurrence of replacement resorption. MATERIAL AND METHODS Fifty-one intruded permanent incisors were studied in 20 boys and 19 girls aged 6 to 17 years. Only three patients were over 12 years of age. Complete intrusion had occurred in 21 teeth, and 31 teeth were classified as immature. Re-eruption was awaited for 37 teeth. The remaining teeth were repositioned orthodontically (7 teeth) or surgically (7 teeth). RESULTS Re-eruption occurred in 35 out of 37 teeth over a period of 3-12 months. After a mean observation period of 4 years ranging from 1-12 years, retained pulp vitality was recorded in 22 teeth (43%). Pulp necrosis had developed in 57%, inflammatory resorption in 26% and replacement resorption in 12%. Whereas all inflammatory resorptions were arrested after long-term calcium hydroxide treatment, replacement resorption always led to complete root resorption. In the analysis all orthodontic and surgical repositioned teeth were combined into an active treatment group. The non-active treatment group consisted of teeth allowed to re-erupt. The distribution of replacement resorption was significantly lower in teeth allowed to re-erupt than in teeth repositioned actively. CONCLUSIONS The best treatment of intruded incisors in 6-12 year-old children is to await re-eruption. Should endodontic treatment be required before re-eruption has occurred, a gingivectomy can be performed to gain access to the root canal.

Traumatized primary anterior teeth: Prognosis related to calcific reactions in the pulp cavity

The frequency of a complicating pulp necrosis and the process of the physiologic root resorption were studied in traumatized primary teeth exhibiting partial or total pulp obliteration. The material comprised 88 incisors in 72 children aged 0.7--5.7 years (mean 2.9 years) at the time of injury. Trauma had resulted either in subluxation (25 teeth), or luxation (13 teeth), whereas the type of injury was unknown in 50 teeth. All cases were observed until eruption of the permanent incisors. Forty-four teeth initially displayed a reversible greyish color. The ultimate finding observed in all teeth was, however, varying degrees of yellow discoloration. Periapical pathologic findings indicative of pulp necrosis were observed in 9 teeth, from 1.6--4 years (mean 3 years) after the time of injury. Extraction was performed immediately, and none of the successional teeth showed developmental disturbances. The process of root resorption was classified as normal in all primary teeth. Subsequent eruption of the permanent successors occurred without any registered complications.