摘要
复杂冠根折是牙外伤中较为严重的一种类型,涉及牙体、牙髓和牙周组织损伤,临床上常用治疗方法包括正畸牵引、外科牵引、意向再植和断冠粘接术等。这些方法能够比较有效地保存患牙,但需要先拔出冠部断端,暴露龈下断面,然后再行粘接修复,可能会导致外伤牙冠根比不协调或牙周问题,给远期疗效带来挑战。近期,笔者尝试冠部断端非拔出技术联合部分断冠粘接术,即保留冠部断端不予拔出,仅沿龈上折裂线和龈下折裂线(髓腔侧)进行粘接,而龈下折裂线(牙周侧)不做处理,旨在简化操作,最大限度地减少对牙周组织的二次损伤,降低牙周并发症的可能,短期内取得了较满意的效果,但粘接强度和远期疗效尚有待观察与评估。
Complicated crown-root fracture is a serious type of dental trauma,involving dental hard tissues,tooth pulp and periodontal tissues.The most commonly recommended treatment methods by International Association of Dental Traumatology(IADT)include orthodontic extrusion,surgical extrusion,intentional replantation and adhesive coronal fragment reattachment,etc.The common feature of these treatment methods is to extract the broken coronal fragment,expose the fracture line and make the restoration.However,the extraction itself and the subsequent treatments will cause various problems,which severely compromise and challenge the long-term prognosis.Recently,we tried a technique including non-extraction of the coronal fragment and partial coronal fragment reattachment.I.E.,the coronal fragment was retained instead of extraction,and the reattachment was only performed along the supragingival fracture line and subgingival fracture line across pulp cavity side only,while the subgingival fracture line across periodontal side was left untreated.Our technique,basing on the concept of periodontal preservation,and aiming at simplifying the operation procedure,reducing the re-injury to periodontal tissues to the greatest extent,and decreasing subsequent periodontal complications as possible,has got satisfying clinical manifestation so far.However,the adhesive strength of the partial coronal fragments reattachment and their long-term prognosis need to be observed and evaluated further.
作者
吴礼安
Wu Li’an(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Clinical Research Center for Oral Diseases,Dept.of Pediatric Dentistry,School of Stomatology,the Fourth Military Medical University,Xi’an 710032,China)
出处
《国际口腔医学杂志》
CAS
CSCD
2023年第6期623-631,共9页
International Journal of Stomatology
基金
陕西省国际合作重点项目(2021KWZ-26)
陕西省卫生健康科研创新团队(2023TD-01)
国家口腔疾病临床医学研究中心专项课题(LCC202204)。
关键词
儿童
恒前牙
复杂冠根折
冠部断端
部分断冠粘接术
children
permanent anterior teeth
complicated crown-root fracture
coronal fragment
partial coronal fragment reattachment
