牙龈瘤切除即刻牙再植

目的:初步探讨牙龈瘤切除即刻牙再植的临床疗效。方法:选择口腔门诊年轻牙龈瘤患者32例50颗牙进行肿瘤切除即刻原牙再植,术后随访观察5年。结果:再植牙5年成功率达77.3%,牙龈瘤无1例复发;5年中累计有7病例10颗再植牙失败,失败原因主要为术后牙根吸收≥1/3根长(占60%)、固定不牢靠(占20%)、继发感染(占20%)。结论:牙龈瘤切除即刻再植牙经适当的临床治疗仍可保留多年。     

48例完全脱位牙再植疗效观察

目的:观察外伤后完全脱位牙再植的临床疗效。方法:对2006年以来到我科就诊的48例52个完全脱位牙,经常规处理后再植复位固定,随访观察2~3年。结果:52个脱位牙再植后经2年以上复查,成功48个,失败4个,成功率92%,离体时间2 h内再植成功率高于2 h后(P<0.05),湿保存较干保存再植成功率高(P<0.05),离体时间越短牙周膜愈合情况越好(P<0.05)。结论:离体时间短、合适的保存介质、牙根面良好的牙周膜活性是完全脱位牙再植成功的重要因素。     

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目的探讨外伤后年轻恒牙脱位再植的临床效果。方法对2004—2008年来武汉市蔡甸区妇幼保健院口腔科就诊的56例7～14岁儿童外伤后年轻恒牙脱位患者的63颗牙,经常规处理后行再植复位固定,随访观察。结果经过1～2年随访观察,63颗外伤脱位牙再植良好50颗,较好8颗,失败5颗,再植成功率为92.06%。结论离体时间短、尽量保护根面牙周膜活性、良好固定和调、必要时行根管治疗等,是年轻恒牙再植成功的重要因素。     

外伤全脱位年轻恒牙再植的临床研究

目的：观察不同离体时间的年轻恒牙再植后的成功率。方法：详细记录60颗全脱位牙离体时间、手术及牙愈合情况，对患者进行1～2年的随访。结果：60颗脱位牙（离体时间为15min～16h）再植后牙周膜愈合26颗（43．3％），其中牙髓成活19颗（31．67％）；骨性愈合31颗（51．67％）；纤维愈合3颗。术后对38颗牙进行了根管治疗。结论：缩短脱位牙的离体时间、尽可能保存牙周膜的活性等是再植成功的重要因素。     

前牙完整性脱位再植根管充填临床应用

目的：评价前牙离体再植根管充填的手术疗效。方法：回顾分析1999年以来收治的96例因外伤致前牙离体脱位患者的临床资料。其中30min至2h前牙离体脱位患者20例,前牙离体脱位超过2h患者76例。结果：76例前牙离体脱位超过2h患者离体牙经处理后,均采用复位再植,固定一次性根管充填,术后显效65例,有效5例,失败6例。30min至2h以内离体牙经处理后再植复位再定,术后显效14例,其中牙髓复活4例,有效4例,失败2例。结论：因外力致完整脱位的自体牙经过处理后复位再植一次性根充治疗有明显的临床疗效。脱位牙离体时间长短关系密切、脱位牙在体外的保存方式是影响成败的主要因素。采用复位再植、固定,根管充填,防止牙骨坏死,根尖感染是目前牙离体再植较理想的术式之一。     

离体再植年轻恒牙根尖诱导临床观察

选择20 例离体再植年轻恒牙,用Vitapex糊剂进行根尖诱导.其中外伤脱位牙18 例,离体时间0.5 h～5 d;手术离体牙2 例,即刻复位.16 例治疗成功,4 例失败,成功率80%.18 例外伤脱位再植牙中治疗成功15 例(83.3%),2 例手术再植牙中治疗成功1例(50%).根尖发育完成所需时间为3～18 个...     

外伤性完全脱位牙即刻再植的临床分析

目的：探讨影响外伤性完全脱位牙即刻再植成功率的因素,观察光固化复合树脂夹板固定脱位牙的临床效果。方法：将外伤性完全脱位的急诊25例30颗牙齿以生理盐水清洗、抗生素浸泡后植入原牙槽窝,用光固化复合树脂夹板将脱位牙与邻牙固定,术后1、3、6、12月复诊行X线检查及牙髓活力测试,判定牙再植是否成功。结果：脱位牙再植成功20颗,成功率为66.7%,失败10颗,失败率33.3%。结论：年轻恒牙特别是离体时间在2h以内的再植成功率高;正确保存脱位牙,处理和贮存过程正确得当的成功率高;光固化复合树脂夹板固定简便易行,美观,易清洁,口腔卫生好,是一种有效的固定方法。     

自体年轻恒牙再植术的临床观察

目的:探讨影响年轻恒牙再植术成功率的原因,以提高临床治愈率。方法:对26例34个外伤脱位年轻恒牙常规处理后原位再植,复位固定,随访观察。结果:经1～2年随访观察,34个外伤脱位牙再植后,生长良好26个牙,较好5个牙,失败3个牙,成功率91.18%。结论:离体时间短、尽量保护根面牙周膜细胞活性、良好的固定和调牙合、必要时进行根管治疗,是保证年轻恒牙再植成功的重要因素。     

牙脱位再植的临床分析

目的对牙脱位后再植的时间、储存介质及牙髓处理进行临床分析并探讨手术成功的影响因素。方法将脱位牙立即用生理盐水冲洗,置于0.25%氯霉素溶液中浸泡5min备用。常规局麻下清创,尽可能保存牙槽窝内的牙周膜,用生理盐水反复冲洗,最后用0.25%氯霉素溶液冲洗,轻刮牙槽窝使之充满血液,将离体牙按牙脱位方向植入并固定。结果随访3年,87例共98颗牙齿成功93颗,成功率94.9%。结论牙脱位特别是离体牙再植手术越早成功率越高。离体牙切忌干放,最好含在嘴里或放在牛奶中就诊。未出现严重牙周组织炎症时,尽可能保存活髓。     

136 例脱位牙再植的远期临床观察

自体牙脱位后再植术是指将因受外伤打击或外科手术时意外损伤,造成牙体牙根完整、完全脱出牙槽窝,无明显牙槽骨骨折的牙,重新植入原来牙槽窝内的一种手术方法。笔者对1992~2000年本科136例脱位再植牙,就再植的术前处理,牙髓治疗时机及固定方法,固定时间等方面进行总结。1资料和方法1.1临床资料136颗再植牙,包括外伤脱落、错拔的牙及个别埋伏牙拔除后重新再植等。男性56名,104颗再植牙,其中上前牙73颗,下前牙31颗,女性患者20名,32颗再植牙,其中上前牙24颗,下前牙8颗。年龄最小6岁,最大45岁。儿童青少年108例约占80%。牙脱位时间最短20min,最…     

完全脱位牙即刻与延迟再植根吸收的动态观察

目的：动态观察实验大鼠再植牙牙根吸收及愈合过程,辅助临床治疗及预防再植牙牙根吸收。方法：30只6周龄SPF级Wistar雄性大鼠,分为6组,每组5只,其中一组为空白对照组。实验组大鼠双侧上颌第一磨牙脱位后再植,每只大鼠随机选取一侧脱位牙齿即刻再植,对侧同名牙则于体外干燥保存30min后再植回牙槽窝。分别于术后1、3、7、14、21d处死,分离上颌骨,拍摄x线片,应用IPP软件测量上颌第一磨牙近中根根周透影面积。标本脱钙后制作切片、HE染色,进行组织学观察。结果：再植牙根尖周透影面积随时间延长而增大,干燥组表现尤其明显;组织学上表现为初期炎症反应较明显,随着炎症发展,牙根表面吸收陷窝逐渐增多、增大,后期即刻组牙髓及牙周膜修复反应明显,干燥组牙槽骨修复反应强烈,牙根、牙周膜逐渐被类骨质样组织替代。结论：再植牙初期以炎症反应为主,后期主要表现为修复反应,即刻与延迟再植导致牙周膜细胞活性不同决定了再植牙根吸收的进展。     

Periodontal healing of exarticulated monkey teeth stored in milk or saliva

Abstract – Saliva has usually been recommended as a storage medium for exarticulated teeth. Recent tissue culture studies have, however, shown that milk has a more suitable osmolaliry than saliva and that milk is a bettter storage medium for human periodontal ligament cell. In the present investigation periodontal healing of replanted monkey teeth has been studied after storage of teeth in milk or saliva before replantation. There was much less root resorption, especially inflammatory resorption, after storage in milk thatn in saliva. Storage of teeth in milk for 3 h before replantation resulted in the same low frequence of root resorptions as was seen after immediate replantation. There was hardly any replacement resorption (ankylosis) seen in the replanted teeth.     

超强纤维在脱位牙固定中的应用

目的：研究超强纤维在脱位牙固定中的临床效果.方法：采用超强纤维对24例32颗脱位牙进行固定,并随访0.5-2年.结果：23例30颗再植牙于0.5-2年观察效果良好.仅1例2颗患牙再植失败,拔除.X线片复查,其中5例8颗分别于术后1-2年发现根尖及根侧有轻微吸收,但无明显松动.余牙均无明显异常,牙龈附着正常,能正常行使功能.结论：超强纤维作为一种新型的材料,对脱位牙进行固定时具有美观、舒适,操作简单,有利于软硬组织愈合及对牙周健康无明显影响等优点.     

The effect of extra-alveolar root filling with calcium hydroxide on periodontal healing after replantation of permanent incisors in monkeys

The effect of calcium hydroxide, used as an extra-alveolar root filling material, on periodontal healing was examined in green vervet monkeys (Cercopithecus aethiopa). Incisors were extracted and a root canal filling of calcium hydroxide paste was processed. Control teeth were replanted after either pulp extirpation or root filling with gutta-percha. In the experimental groups, the extra-alveolar period was either 18 or 120 minutes. The animals were killed eight weeks after replantation, and the replanted teeth were examined histologically. The histologic parameters recorded for each tooth were surface resorption, inflammatory resorption, replacement resorption (ankylosis), periapical inflammatory changes, and downgrowth of pocket epithelium. Teeth with canals filled with calcium hydroxide that had an extra-alveolar time period of 18 minutes, showed noticeably more replacement resorption than either the teeth with canals filled with gutta-percha or those with extirpated pulps. Calcium hydroxide paste may diffuse through the apical foramen, thus injuring the periodontal ligament in the apical region. Consequently, the use of calcium hydroxide does not seem justified in the initial treatment of avulsed teeth, but it can be used after some weeks when periodontal ligament healing has progressed.     

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影响牙再植的因素众多,牙再植的成功率并不高。如何改善牙再植的预后一直是儿童牙科临床面临的一大挑战。牙再植的过程一般包括患牙及牙槽窝的处理、惠牙再植和固定。辅助治疗则包括全身性抗生素的应用、局部抗菌措施、破伤风疫苗的强化等。由于牙根发育程度的不同以及惠牙根面牙周膜细胞活性状态的差异等原因,患牙的根面处理及再植后的固定措施有所差异。此外,还需根据患牙牙根发育是否完全、患牙根面是否有活性牙周膜细胞覆盖等对患牙牙髓进行相应的观察或处理。本文拟就这些方面进行简要的介绍。     

Repair processes in the cervical region of replanted and transplanted teeth in monkeys

The repair processes in the cervical region of replanted teeth where the periodontal ligament was injured by either extensive drying or removal was studied. These repair processes were related to various clinical factors, such as splinting, traumatic occlusion and exactness of repositioning. Permanent incisors were extracted, root filled extraorally and allotted to the following experimental groups: (1) PDL injured by drying, no splinting; (2) PDL injured by drying, splinting for 2 weeks; (3) PDL injured by drying, replanted tooth in traumatic occlusion; (4) PDL injured by drying, no splinting, non-exact repositioning of the replanted tooth; (5) PDL removed, no splinting. The animals were sacrificed 8 weeks after replantation and the replanted teeth examined histometrically. The different groups demonstrated area with normal periodontal ligament extending from 0.4 to 1 mm apically from the crestal margin, where the greatest extent was found in teeth with non-exact repositioning. The possible role of the gingiva in these repair processes is discussed.     

Periodontal healing of extracted dogs' teeth air-dried for extended periods and soaked in various media

Abstract The aim of this study was to determine the periodontal healing of replanted dogs’ teeth which, after extended extra-oral dry times, had been soaked in various media before replantation. Incisors and premolars of beagle dogs were root canal treated, extracted and bench dried. The teeth were grouped according to dry times of 30, 45 and 60 minutes. Each group of teeth was soaked in one of three media, Hank's balanced salt solution, Via Span (Belzer UW-CSS, Dupont Pharmaceuticals), or Conditioned Medium (supernatant of confluent culture of human gingival fibroblasts) for 30 minutes before replantation. Controls consisted of teeth extracted and replanted without drying or soaking (negative control), and bench-dried teeth replanted without soaking in the media (positive control). The dogs were killed 6 months after replantation of the teeth, which were prepared for histologic evaluation. Five um cross-sections (every 70 Jim) of the root and surrounding tissue were evaluated for healing/resorption according to Andreasen's criteria. The best healing occurred for the roots which had been immediately replanted. Healing in the positive control groups decreased with increased dry time. For the 30–minute dry time groups, soaking in media had no beneficial effect on periodontal healing compared with the controls. Soaking in ViaSpan resulted in an increased healing incidence for both the 45- and 60- minute bench-dried groups while soaking in the other media had no consistent beneficial effect. It appears from this study that an avulsed tooth that has been left dry for 30 minutes should be replanted immediately without soaking. However, teeth that have been dry for 45 or 60 minutes would benefit from soaking for 30 minutes in ViaSpan.     

Periodontal response to two intracanal medicaments in replanted monkey incisors

Abstract – Intracanal medicaments are recommended for use in replanted teeth to inhibit inflammatory root resorption. This study compared the effect of calcium hydroxide (Pulpdent^®) and a corticosteroid-antibiotic paste (Ledermix^®) on periodontal healing and root resorption following replantation. Incisors of eight Macaca fascicularis monkeys were extracted, stored dry for 15 min and replanted. After 11 days, root canals in two adjacent maxillary incisors were treated with one medicament and contralateral incisors with the other medicament, or left as untreated controls. Animals were sacrificed 8 weeks later and the teeth prepared for histomorphometric evaluation of periodontal ligament inflammation and root resorption. Periodontal ligament inflammation and inflammatory root resorption were markedly inhibited by both calcium hydroxide and corticosteroid-antibiotic relative to untreated controls. Replacement resorption was lowest in the corticosteroid-antibiotic group, and significantly ( P <0.05) more normal periodontal ligament was present in this group (79.6%) than in calcium hydroxide and control groups (64.6% and 62.7%, respectively). Treatment with the corticosteroid-antibiotic inhibited inflammatory resorption and was slightly more effective than calcium hydroxide in producing a periodontal healing response.