Orthodontic traction has been suggested as the treatment of choice for intrusive luxation injuries. Prior research has shown orthodontic forces to be ineffective in the presence of ankylosis or in cases with zero mobility following the injury.
If orthodontic traction is to be effective, it must be initiated prior to the onset of ankylosis. The purpose of this study was to describe the effects of intrusive luxation at various times following the injury, and to determine the time of the onset of ankylosis, and to examine what effect immediate partial luxation has on the onset of ankylosis.
Eight young mongrel dogs were utilized for this study. Intrusive luxation was produced with an axial impact using a gravity hammer and a specially designed holding device on 4 teeth (2 max. and 2 man. first premolars) in each dog. The teeth were intruded approximately 3-4mm in an axial direction. One maxillary and one mandibular premolars were partially luxated with the other two teeth being untouched.
Pre and posttrauma tooth position was documented with plaster models and radiographs taken with an individualized X-ray jig. Dogs were sacrificed immediately following the injury and at 1,2,4,7,10,14 and 21 days respectively. Tetracycline was administered as a vital bone marker 24 hours before sacrifice. Block sections of the tooth and alveolus were prepared for decalcified and non decalcified histologic sections.
The effects of traumatic intrusion were analyzed by means of model casts, radiographs, tetracycline bone marking and histologic preparations.
The results obtained were as follows:
I. The animal sacrificed immediately following the injury displayed alveolar fractures, torn periodontal ligaments, and areas of direct tooth-bone contact.
2. The odontoblastic layer of the pulp was disorganized as early as 24 hours after the injury. 3. Bony remodeling was noted at 4 days along with active surface resorption. 4. Ankylosis was first seen 7 days after the injury.
5. Osteogenesis in the dentin (thick tetracycline bands) was observed 7 days after the injury. 6. There was no progressive root resorption and ankylosis where the periodontal ligament has been healed.
7. The Luxated group showed significantly more root resorption and ankylosis than the Nonluxated group with increased observation periods.
The results suggest that ankylosis may occur within the first week following the injury, and hence orthodontic traction should be initiated as soon after the injury as possible.
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