2种方法固定外伤松动牙的疗效比较

目的本研究比较玻璃纤维树脂夹板、钢丝树脂夹板两种方法固定外伤松动前牙的临床疗效。方法 46例恒前牙外伤患者,随机分为两组,实验组使用玻璃纤维树脂夹板固定,对照组使用钢丝树脂夹板固定,分别固定外伤松动牙23颗。观察使用两种固定方法2周后拆除夹板时以及3个月后的外伤牙松动度的变化情况,同时比较两组固定方法所需操作时间的差异。结果实验组和对照组的外伤松动牙经过固定治疗后松动度均明显下降,具有良好的效果。两种固定法在这两个时间观察点时患牙松动度的变化在统计学上无显著差别(P>0.05)。实验组所需操作时间明显缩短,两组在统计学上有显著差别(P<0.01)。结论在短期疗效上来看,两种固定方法都能达到固定外伤松动牙的效果,但玻璃纤维树脂夹板临床操作时间更短。     

尼龙丝与钢丝树脂夹板两种固定外伤松动牙的效果比较

目的对比研究尼龙丝、钢丝树脂夹板固定外伤松动牙的临床疗效。方法实验组使用尼龙丝树脂夹板固定法，对照组使用钢丝树脂夹板固定法，随机各固定外伤松动牙40颗。对比观察使用两组固定方法后，外伤牙的松动度在拆除夹板时、1个月以后、3个月以后的变化情况以及两组固定方法所需的平均操作时间。应用SPSS10．0软件对相关数据进行统计学检验。结果实验组与对照组的外伤松动牙，经固定治疗后松动度均明显下降，达到了固定的效果。比较使用两组固定方法在上述3个时间观察点上患牙松动度的下降值在统计学上均无显著性差别（P〉0．05）；比较两组固定方法的平均操作时间，实验组所需操作时间明显短，两组在统计学上差别显著（P〈0．01）。结论同样能达到固定外伤松动牙的效果，使用尼龙丝树脂夹板固定省时。     

前牙外伤邻间隙粘结固定的临床观察

目的　观察Super-bond C&B粘结邻间隙固定前牙外伤的临床效果。方法　选择我院口腔科门诊因外伤导致牙齿Ⅱ～Ⅲ度松动或牙完全脱位的病人179例共计474颗患牙,采用Super-bond C&B粘结邻间隙(E)固定外伤严重松动或脱位牙,并与常规金属丝结扎法(A)、牙弓夹板法(B)、钢丝釉质粘合剂法(C)、片段方丝弓技术松牙固定法(D)在牙周健康和固定疗效进行比较,观察疗效。结果　E组的牙龈指数(GI)和龈沟出血指数(SBI)均显著低于A、B、C、D组(P＜0.01);固定疗效优于A、B、C、D组(P＜0.01)。结论　前牙外伤的固定治疗,Super-bond C&B邻间隙粘结法是一种牙周刺激小,疗效可靠的方法。     

钢丝粘结固位替牙早期外伤恒前牙的研究

目的观察钢丝粘结固位替牙早期外伤松动的恒前牙临床效果。方法对16例36颗外伤松动恒前牙进行钢丝粘固位并进行为期半年的疗效评估。结果本组病例经临床检查和X射线观察,患牙无松动,功能良好,牙周膜宽度正常。结论钢丝粘结固定法效果稳定可靠,特别适用于混合牙列时期的儿童前牙外伤病例。     

两种方法固定外伤松动恒前牙的疗效分析

目的：对比研究扁钢丝＋树脂夹板、固定矫治技术固定外伤松动恒前牙的临床疗效。方法：64例恒前牙外伤患者，随机分为两组，分别采用扁钢丝＋树脂夹板固定法和固定矫治技术固定法，对比观察两种方法后，外伤牙松动的变化以及牙周检测指标的变化情况，并进行统计学分析。结果：实验组与对照组的外伤松动牙，经固定治疗后松动度均明显下降，达到固定效果。使用两种固定方法后患牙松动度的下降值在统计学上无显著性差别；两组固定方法的菌斑指数（PLI）、牙龈指数（GI）在统计学上差别显著（P〈0．01），实验组明显优于对照组。结论：扁钢丝＋树脂夹板固定法是一种牙周刺激性小，易于清洁，疗效可靠的松动牙固定方法。     

Edgwise矫治器在固定外伤松动牙中的应用

目的 :寻求一种固定乳牙或替牙期外伤松动牙的新方法。方法 :4 3例 4 14岁的 6 6颗外伤松动牙 ,常规粘结托槽、方丝弓及结扎丝“8“字结扎固定 ,3月后拆除。治疗前及治疗后 1月、2月、3月、半年拍摄根尖片 ,观察愈合。结果 :75 .7%正常愈合 ,15 .2 %根吸收 ,3.0 %牙冠变色 ,3.0 %骨性愈合。结论 :Edgwise托槽应用于外伤松动牙的固定安全、简便、损伤小、易清洁 ,效果满意。     

全牙列垫治疗年轻恒牙脱位、半脱位的临床观察

前牙外伤以7~9岁替牙期的儿童多见,约占恒牙外伤的50%~70%[1]。传统的固定方法有:钢丝结扎固定法、牙弓夹板固定法、复合树脂固定法、复合树脂 弓丝固定法、托槽弓丝结扎固定法等。由于替牙期儿童牙齿长短不一,乳牙松动,恒牙未萌或萌出不足,给受伤牙固定带来困难。笔者应用全牙     

牙外伤两种固定方法的比较

牙外伤常规治疗方法多为金属丝结扎,牙弓夹板固定,树脂粘结固定等,存在操作困难、二次损伤、效果不理想儿童不易接受等缺点。我科自2004年来多以方丝弓矫治器法固定外伤牙,取得比较好的效果。     

尼龙线在外伤松动牙、脱位牙及牙槽突骨折复位固定的应用

目的 :介绍1种新的外伤牙松动、脱位及牙槽突骨折复位固定方法。方法 :通过正确的复位,应用0.2 mm尼龙线,将松动或脱位牙两边1~2个正常牙上与需固定的牙连续结扎在一起,反复结扎3道进行固定。结果:经尼龙线在外伤松动牙、脱位牙及牙槽突骨折复位固定方面5年的临床应用,共治疗患者106例,患牙265颗,上前牙172颗、下前牙84颗、前磨牙9颗,伴牙槽突骨折13例。牙周有红肿及溢脓、患牙疼痛不适、患牙松动度大于Ⅰ度以上、X片显示牙槽骨及牙根有吸收,均评价为失败病例。固定后通过1~36个月的随访,共失败10例18颗牙,成功率93.2%。结论 :尼龙线固定外伤松动牙、脱位牙及伴有牙槽突骨折移位牙时,是一种行之有效的方法 ,在固位的稳定性、美观、舒适性方面均取得较好临床效果。     

尼龙丝树脂夹板固定外伤松动牙的临床疗效分析

目的观察尼龙丝树脂夹板固定法治疗外伤性松动牙的临床效果。方法选择100例牙外伤松动患者,随机分为试验组和对照组,试验组采用尼龙丝树脂夹板固定法治疗,对照组采用牙弓夹板结扎固定法治疗,观察疗效。结果试验组有效率为96.00%,对照组为80.00%,经卡方检验两者差异有显著性(P<0.05)。结论尼龙丝树脂夹板固定法固定效果佳,是一种美观,易清洁,刺激性小的松动牙固定方法。     

可摘式钛合金牙周夹板对慢性牙周炎松动牙的固定

目的 探讨可摘式钛合金牙周夹板对慢性牙周炎松动牙的临床固定效果。方法 将30例需做可摘式牙周夹板的慢性牙周炎患者随机分两组，每组15人。即实验组：制作钛舍金牙周夹板23件，固定松动牙115颗；对照组：制作钴铬合金牙周夹板2l件，固定松动牙106颗。戴用夹板前后均以LHLY型牙动度位移测量仪记录患者牙齿松动度数值的变化，用以比较两种牙周夹板的疗效。结果 两组患者分别在戴用牙周夹板1月、3月、半年、1年后进行复查，用测量仪所测牙齿松动度数值均较治疗前不同程度减小，临床有效率均为93％。但钛合金夹板和钴铬合金夹板对牙周病松动牙的固定疗效比较无差异。结论 可摘式钛合金牙周夹板对牙周病松动牙有良好的临床固定效果，是牙周病治疗理想的修复方法。但是钛合金夹板是否比钴铬舍金夹板对牙周病松动牙的固定疗效更好尚需要进一步研究。     

护理指导对外伤松动牙在树脂纤维弹性夹板固定过程中口腔卫生情况的影响

目的 观察口腔护理指导在树脂纤维弹性夹板固定外伤松动牙过程中对口腔卫生情况的影响。方法 收集51例因外伤导致牙松动的病例(349颗牙齿),行树脂纤维夹板固定处理后,随机分为2组：对照组(25例,152颗牙齿)行常规医嘱;试验组(26例,197颗牙齿)予以常规医嘱+口腔卫生护理指导。患者于术后第2 w进行复查,观察树脂纤维夹板范围内的口腔卫生情况,包括牙唇侧表面软垢形成程度,牙周探诊深度及牙周探诊出血(Bleeding on probing,BOP) 阳性率。结果 试验组的牙齿表面白色软垢形成程度明显低于对照组(P<0.05);试验组的龈沟深度为(2.68±0.36) mm,对照组为(3.23±0.45) mm,差异无统计学意义;试验组的BOP阳性率为31.98%,低于对照组的BOP阳性率77.68% (P< 0.05)。结论 口腔护理指导在外伤松动牙树脂纤维弹性夹板固定过程中十分必要,可明显改善患者口腔卫生环境,有助于预防牙龈炎症的发生。     

Rigidity of various fixation methods used as dental splints

Abstract Horizontal and vertical rigidity of teeth fixed with seven types of denial splints were evaluated by two tooth mobility measuring devices. Altogether 21 dissected sheep mandibles including soft tissues were used for the experiments in which Fermit, flexible wire-composite, Kevlar, Fiber, Protemp, rigid wire-composite and Triad Gel splints were applied to four incisors. The mean rigidity of the central incisors within the splint was measured by means of Mühlemann periodontometer (horizontal mobility) and Periotest (horizontal and vertical mobilities). Mobility values of teeth before splinting were used as covariants and the values with the splints were illustrated as adjusted mobility. Statistical significance between the rigidity of various splints was analyzed by an unpaired t-test. It was shown that the most rigid splints both in horizontal and vertical directions were Triad Gel, rigid wire-composite and Fermit splints. Kevlar and Fiber splint allowed more horizontal movement than other splints. Protemp and flexible wire-composite splints proved to produce adequate lateral support for the fixed teeth and allowed vertical flexibility which is experimentally known to improve periodontal healing of luxated teeth.     

Influence of wire extension and type on splint rigidity – evaluation by a dynamic and a static measuring method

Abstract – Objectives: To evaluate the influence of wire dimension and wire length on the splint rigidity of wire‐composite splints in vitro. Materials and Methods: A custom‐made artificial model was used. The central incisors simulated ‘injured’ teeth with increased mobility, and the lateral incisors and canines served as ‘uninjured’ teeth with physiological mobility. To assess horizontal and vertical tooth mobility before and after splinting, the Periotest and Zwick methods were applied. Teeth 13–23 were splinted using wire‐composite splint 1 (WCS1; Dentaflex 0.45 mm) and wire‐composite splint 2 (WCS2; Strengtheners 0.8 × 1.8 mm). Splint length was varied by successively shortening the wire. The influence of wire dimension was tested using t‐test and Wilcoxon–Mann–Whitney test with the Bonferroni‐Holm procedure (α = 0.05). To test the influence of wire length, anova and Kruskal–Wallis tests as well as Tukey range and Wilcoxon test with Bonferroni‐Holm procedure were applied (α = 0.05). Results: Wire dimension significantly influenced splint rigidity (P < 0.05). The wire length significantly influenced the splint rigidity of WCS1 in the horizontal dimension and WCS2 in the horizontal and vertical dimensions (P < 0.05). Splint rigidity was significantly reduced when splinting only ‘injured’ teeth compared with splints including ‘uninjured’ adjacent teeth (P < 0.05). No differences were found between splints including one or two ‘uninjured’ teeth on each side (P > 0.05). Conclusion: WCS1 is flexible compared with the more rigid WCS2. The wire length influences the rigidity. To ensure adequate fixation and reduce the risk of enamel damage during splint removal, the splint should include only one ‘uninjured’ tooth bilaterally.     

Rigidity of various fixation methods used as dental splints.

Horizontal and vertical rigidity of teeth fixed with seven types of dental splints were evaluated by two tooth mobility measuring devices. Altogether 21 dissected sheep mandibles including soft tissues were used for the experiments in which Fermit, flexible wire-composite, Kevlar, Fiber, Protemp, rigid wire-composite and Triad Gel splints were applied to four incisors. The mean rigidity of the central incisors within the splint was measured by means of Mühlemann periodontometer (horizontal mobility) and Periotest (horizontal and vertical mobilities). Mobility values of teeth before splinting were used as covariants and the values with the splints were illustrated as adjusted mobility. Statistical significance between the rigidity of various splints was analyzed by an unpaired t-test. It was shown that the most rigid splints both in horizontal and vertical directions were Triad Gel, rigid wire-composite and Fermit splints. Kevlar and Fiber splint allowed more horizontal movement than other splints. Protemp and flexible wire-composite splints proved to produce adequate lateral support for the fixed teeth and allowed vertical flexibility which is experimentally known to improve periodontal healing of luxated teeth.     

Rigidity of commonly used dental trauma splints

Abstract – Background/Aims: The stability of immobilization devices varies from flexible to rigid, depending on the trauma. We evaluated the rigidity of various commonly used splints in vitro Material and Methods: An acrylic resin model was used. The central incisors simulated injured teeth, with increased vertical and horizontal mobility. The lateral incisors and canines stimulated uninjured teeth. Tooth mobility was measured with the Periotest^® device. Vertical and horizontal measurements were made before and after splinting, and the difference between values was defined as the splint effect. We evaluated 4 composite splints, 3 wire‐composite splints, a titanium trauma splint, a titanium ring splint, a bracket splint, and 2 Schuchardt splints Results: For all injured teeth and all splints, there was a significant splint effect for the vertical and horizontal dimensions (P < 0.05). For injured teeth, the composite splints produced the largest changes in vertical tooth mobility; wire‐composite splints 1 and 2, using orthodontic wires, produced the smallest vertical splint effects. For uninjured teeth, the Schuchardt 1 splint and the bracket splint produced the largest splint effects; wire‐composite splints 1 and 2 produced only a slight change in tooth mobility. Composite splints 2 and 3 produced the largest horizontal splint effects for injured teeth, and the 4 composite splints produced the largest horizontal splint effects for uninjured teeth. The most horizontally flexible splints were the titanium trauma splint and wire‐composite splints 1 and 2. Conclusions: According to the current guidelines and within the limits of an in vitro study, it can be stated that flexible or semirigid splints such as the titanium trauma splint and wire‐composite splints 1 and 2 are appropriate for splinting teeth with dislocation injuries and root fractures, whereas rigid splints such as wire‐composite splint 3 and the titanium ring splint can be used to treat alveolar process fractures.     

The effect of splint material and thickness on tooth mobility after extraction and replantation using a human cadaveric model

Although current guidelines for the treatment of traumatic injuries recommend the use of 'flexible' splints, the precise definition of what is considered flexible versus rigid has not been rigorously defined, leaving the clinician with a wide range of options for this critical factor. The purpose of this study was to quantify and compare the effect of eight different splints on tooth mobility after extraction and replantation using a human cadaveric model. Following strict selection criteria including complete root maturation, lack of periodontal disease, normal bone levels, and crown integrity, a maxillary central incisor was atraumatically extracted and splinted with eight different splints. The experimental splints included a 30-pound test monofilament nylon-composite splint and six wire-composite splints made of wires of 0.012' (0.3 mm), 0.016' (0.4 mm), or 0.020' (0.5 mm) diameter stainless steel (SS) or nickel titanium (NT). A direct composite splint represented the most rigid type of splint. These eight splints were applied five times each, and tooth mobility was measured before and after each splint was applied. The average splint effect, defined as the difference between the presplint and the postsplint measurements quantified using the Periotest, was calculated for each splint and compared. No significant differences were found between the nylon-composite and the wire-composite splints. There was significantly less tooth mobility with the direct composite splint compared to all other splints. In conclusion, the results of this study suggest that nylon and SS or NT wires up to 0.016' diameter are significantly more flexible than direct composite splints and thus may be better suited for the splinting and management of traumatized teeth.