A prospective longitudinal outcome study of extrusive luxation injuries to the permanent maxillary incisors of children.

摘要

A prospective longitudinal outcome study was undertaken to determine the variables that significantly influenced the survival of permanent maxillary incisors of children who had experienced extrusive luxation injuries. Information was available for 35 patients (18 males; 17 females) representing 55 teeth. The mean patient age at the time of injury was 10.6 years (range: 7.1 to 17.8 years). The median time elapsed to follow-up was 1332 days (range: 423 to 2887 days). Survival analysis techniques were used to identify variables significantly related to the prognosis of these teeth. The loss of an incisor following extrusion injury was uncommon as only one tooth in the entire sample required extraction. There was not a statistically significant difference in survival between severely extruded teeth and avulsions that had been stored in physiologic media (p > 0.10). Pulpal necrosis (PN) was the most common complication following injury (43 per cent). Although not statistically significant, a trend towards increased PN was found with more severely injured teeth ( p = 0.20, Relative Risk = 2.08). Pulp canal obliteration (PCO) was the second most common complication (35 per cent). The degree of extrusion was proven to be statistically significant in the development of PCO ( p = 0.03, Relative Risk = 0.33). Root resorption was an uncommon event (5.6 per cent). With this information, parents may be informed that although their child's extruded permanent maxillary incisor will most likely be retained for a number of years, PCO and/or PN and root canal treatment may be direct consequences. This study represents the first survival analysis of extrusive luxation injuries to the permanent maxillary incisors of pre-adolescents and adolescents.