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2010, Número 4

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Rev Odont Mex 2010; 14 (4)


Tratamiento del diente avulsionado: Caso clínico, seguimiento a 5 años

Cortés GMI, Hernández PJ, Valenzuela EE

Idioma: Español
Referencias bibliográficas: 82
Paginas: 249-257
Archivo PDF: 294.48 Kb.


RESUMEN

En los niños son frecuentes los accidentes en bicicleta y las caídas en el patio de juegos, los cuales provocan lesiones en el tejido periodontal sin provocar fractura o destrucción de las estructuras dentarias, de tal manera que la fuerza del traumatismo es absorbida por las estructuras de soporte, y el ligamento periodontal puede presentar desde una lesión mínima como es la concusión, hasta la ruptura completa como es la avulsión. Al establecer un pronóstico para dientes avulsionados, la vitalidad del ligamento periodontal es mucho más importante que la pulpar y el tratamiento es dirigido al restablecimiento del suministro sanguíneo, por lo que estas lesiones deben atenderse lo más rápidamente posible. Esto hace necesario un diagnóstico correcto y un tratamiento adecuado y rápido. Se presenta a la Clínica de Odontopediatría, un paciente femenino de 8 años de edad reportando un traumatismo directo en la zona anterior del maxilar superior, a la inspección clínica se observa el diente 11 avulsionado, con ápice abierto; se procedió a reimplantarlo en su alvéolo, se ferulizó, se suturaron tejidos blandos; no se requirió tratamiento endodóntico. La férula se retiró a los catorce días. Se realizaron citas de control a los 3, 14 y 19 meses, y posteriormente citas anuales durante cinco años. Actualmente el ápice se encuentra cerrado. Con el vitalómetro se obtuvieron valores normales en relación al diente homólogo, no se observan alteraciones clínicas ni radiográficas. Conclusión: Es posible mantener la vitalidad pulpar y periodontal, en un diente reimplantado cuando la maniobra quirúrgica no exceda de una hora.


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