RESUMEN
The present case aims to describe the management of a complicated crown en masse fracture in a maxillary central incisor due to trauma by intentional replantation as the chosen treatment modality. Intentional replantation aiming towards successful endodontic therapy comprises intentional therapeutic extraction of the tooth and an endodontic procedure in a controlled environment followed by replantation. A 24-year-old female patient presented to the department with a chief complaint of broken upper front teeth following trauma. The teeth were tender on percussion. The periapical radiographic examination revealed a complicated fracture involving the pulp without significant periapical changes. A diagnosis of Ellis Class III was established and intentional reimplantation was planned with the patients consent. Following an atraumatic extraction, conventional root canal treatment was completed. Subsequently, a fibre-post was used to reinforce the tooth structure. The tooth was placed back into the socket and splinted. One year of follow up examination revealed absence of pain and periapical healing. The treatment yielded a clinical, aesthetic and functionally satisfactory result, establishing intentional replantation to be a feasible treatment option in complicated crown en masse fracture of the tooth.
RESUMEN
BACKGROUND: When the teeth are separated from the alveolar fossa, the periodontal membrane breaks, and the residual periodontal membrane on the avulsed tooth root surface changes from three-dimensional to two-dimensional, thus losing the role of scaffold, and leading to root bone adhesion after replantation of avulsed tooth. How to develop a three-dimensional sustained-release scaffold material that can adhere to the root surface with a certain thickness and strength is one of the key factors for successful regeneration of avulsed tooth periodontal membrane. OBJECTIVE: To construct a three-dimensional periodontal biomimetic membrane that can adhere to the avulsed tooth root surface and allow sustained-release of growth factors. METHODS: Poly(lactic-co-glycolic acid) (PLGA) membrane was prepared using electrospinning technique. The effects of dichloromethane and dimethylformamide mixture, hexafluoroisopropanol, and trichloromethane on electrospun membrane were investigated to obtain the optimal electrospinning solvent. Chitosan microspheres were prepared by electrospray and ion cross-linking techniques. The effects of molecular weight (50, 000, 100, 000) and mass concentration (10, 20 g/L) of chitosan, sodium tripolyphosphate concentration (2%, 5%, 10%) and voltage (14, 28 kV) on chitosan microspheres were studied to screen the optimum parameters. Chitosan microspheres containing stromal cell-derived factor-1 (optimal parameter design) were constructed. The release rate of stromal cell-derived factor-1 alpha in vitro was determined. First, the root surface of teeth was wrapped with electrospun PLGA membrane, then chitosan microspheres were dripped on the surface, and finally the surface was wrapped with a thin layer of electrospun PLGA. Thus, PLGA-chitosan-PLGA biomimetic membrane was constructed. RESULTS AND CONCLUSION: Electrospun PLGA membrane prepared with hexafluoroisopropanol as electrospinning solvent had the smallest average diameter and the largest porosity. When the relative molecular weight of chitosan was 50, 000 and the mass concentration was 20 g/L, the size of chitosan microspheres was basically the same, and the average diameter was 366. 6 μm. In addition, chitosan microsphere had good monodispersity, fullness, and stability. Chitosan microspheres formed under 28 kV voltage and were more in line with the requirements of biomimetic membrane for avulsed tooth. The surface of microspheres prepared by 5% sodium tripolyphosphate had medium-sized pores, which are most conducive to clinical periodontal membrane regeneration. Chitosan microspheres can sustainably release stromal cell derived factor 1alpha for about 1 month. In this study, we constructed a three-dimensional PLGA-chitosan-PLGA periodontal biomimetic membrane that can adhere to the avulsed tooth root surface and allow sustained-release of growth factors and obtained the optimal parameters of constructing the periodontal biomimetic membrane. Based on the PLGA-chitosan-PLGA periodontal biomimetic membrane, the effect and mechanism of tissue engineering on replantation of avulsed tooth can be further studied.
RESUMEN
Objective@#To investigate the knowledge of pupils’ parents for the emergency treatment of dental trauma in Chancheng of Foshan. @*Methods @#By the method of random sampling, a total of 320 parents from 5 primary schools of Chancheng District was selected for questionnaire survey on the treatment method of children’s dental trauma. Chi square test was used for statistical analysis@*Results@#40.6% of the parents didn’t know that the anterior teeth of a nine-year-old child was permanent. 66.2% of parents didn’t know suitable methods to deal with the avulsed tooth. 72.2% parents didn’t selected the corrected preservation medium for the avulsed tooth. 95.6% of parents believed they needed to learn more knowledge of emergency treatment for dental trauma. @*Conclusion @#The present study showed that the knowledge of parents in Chancheng of Foshan about the emergency treatment of dental trauma is inadequate and related education is necessary.