年轻恒前牙冠折损伤程度和露髓时间对活髓切断术疗效的影响

目的：对外伤引起的年轻恒前牙冠折露髓行活髓切断术，并于2年以上追踪观察其根管、根尖孔发育情况。方法：72例外伤冠折露髓牙，采用活髓切断术切断冠部牙髓，保留根髓活力，促进牙根发育。结果：72例患牙中，轻度损伤58例，治疗成功率为93．1％；重度损伤14例，成功率为64．2％，总成功率为87．5％。结论：活髓切断术是外伤冠折露髓的首选治疗方法。     

氢氧化钙碘仿糊剂在活髓切断术中的应用

氢氧化钙碘仿糊剂在活髓切断术中的应用广东省口腔医院（５１０２６０）叶小雅前牙因外伤等意外因素导致冠折露髓，通常是根管充填后再修复。对牙根尚未发育完全的年轻恒牙存在一个诱导根尖形成的问题［１］。作者用氢氧化钙碘仿糊剂作盖髓剂，治疗２７例３２颗因外伤所致...     

年轻恒牙的外伤治疗

在许多国家,牙外伤已经严重影响着青少年的口腔健康,外伤所累及的年轻恒牙在形态和结构上尚未完全发育成熟,根尖孔开放,髓腔宽大,根管壁薄。当年轻恒牙发生冠折和脱位性损伤时,治疗方法的选择对其预后显得尤为重要。年轻恒牙的牙本质小管比成熟恒牙的粗大,外伤冠折累及牙本质时,细菌容易进入牙本质小管感染牙髓;牙本质长期暴露,可造成牙髓坏死和牙冠变色。年轻恒牙外伤后应尽量保存暴露的活髓,选择氢氧化钙行盖髓术或活髓切断术;年轻恒牙即便发生牙髓坏死,也应选择根尖诱导形成术,促进牙根继续发育完成。     

部分活髓切断术应用于年轻恒牙冠折露髓的临床研究

目的 观察部分活髓切断术治疗年轻恒牙冠折露髓的临床效果。方法 对采用部分活髓切断术治疗的44例冠折露髓患者的46颗年轻恒前牙进行1～6年的临床回顾性观察。结果 其中一颗牙齿在治疗后一年因修复体脱落而致牙髓坏死。其余45颗牙齿均治疗成功，成功率为97．81％。结论 对于冠折露髓的年轻恒牙，部分活髓切断术是成功而有效的治疗方法。     

抗生素药捻在根管消毒中的应用

牙根尚未发育完全的伴有根尖病变的年轻恒牙,或是盖髓术及活髓切断术失败的年轻恒牙,常需采用根尖诱导形成术,使牙根继续发育。通常认为,在根尖诱导形成术中控制根管内感染和诱导剂的应用是两个重要的治疗环节。然而,近年许多学者认为,消除根管内感染和尖周组织炎症...     

年轻恒前牙活髓切断术的临床疗效观察

目的 观察年轻恒前牙活髓切断术的临床疗效。方法 用活髓切断术治疗２０颗冠折露髓后３小时－１个月年轻恒前牙,术后追踪观察６个月－３年,结果 ２０颗年轻恒前牙有牙本质桥形成,牙根最终发育完成,其中仅１颗牙出现管腔钙化。结论 年轻恒牙活髓切断术适应证较宽,成功的关键在于掌握切髓的深度,使保留的牙髓正常,牙根发育程度及牙髓状况影响活髓切除术的疗效。     

年轻上颌切牙冠折露髓的预后及影响因素回顾分析

目的 回顾分析年轻恒牙冠折露髓后的预后及其影响因素.方法 对1991-2008年就诊于北京大学口腔医院儿童口腔科的冠折露髓年轻恒牙的病历资料进行回顾分析,要求患者初诊治疗为活髓切断术或直接盖髓后改行活髓切断术且患者复诊时间大于2年.记录患者的年龄、初诊距外伤时间(即初诊时间)、牙根发育程度、松动度及叩痛,分析治疗效果及...     

光固化氢氧化钙在年轻恒牙直接盖髓术中的疗效观察

直接盖髓术是用药物覆盖暴露的牙髓以促进牙髓愈合和修复的治疗。多用于龋病治疗时意外穿髓和外伤导致意外露髓。由于年轻恒牙的牙根尚未完全发育,根尖孔尚未形成,如果此时进行根管治疗效果不佳。如能通过直接盖髓术促进牙髓组织修复,牙根继续发育,根尖形成,将有利于保留患牙。笔者用光固化氢氧化钙作为盖髓剂对年轻牙外伤性露髓、意外穿髓、临床无明显症状的龋源性露髓牙进行了直接盖术,获得满意的效果。     

MTA用于冠折露髓年轻恒牙活髓切断术1例

对1例10岁儿童恒牙冠折用MTA作为盖髓剂行活髓切断术,随访26个月,治疗牙无临床症状,牙髓有活力,根尖孔形成。     

年轻恒前牙冠折露髓部分活髓切断术的疗效

目的研究年轻恒前牙冠折露髓部分活髓切断术的疗效。方法 120颗患牙中,有70颗采用部分活髓切断术,有50颗采用传统的活髓切断术,统计两组的成功率,并进行比较。结果部分活髓切断术和传统活髓切断术的成功率分别为91.7%和85.4%。结论部分活髓切断术是年轻恒牙冠折露髓一种理想的治疗方法,可以较长久的保存牙髓的活力,继续发挥其固有的功能,促进牙根的继续发育。     

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目的比较部分活髓切断术和间接盖髓术两种方法治疗年轻恒前牙外伤冠折近髓的临床疗效,为临床寻求更佳治疗方法。方法对2005—2008年来济宁口腔医院儿童牙病科就诊的24例前牙外伤患者的31颗冠折近髓的患牙,按患者的就诊顺序随机分成部分活髓切断组(16颗)和间接盖髓组(15颗),分别采用部分活髓切断术和间接盖髓术对患牙进行治疗,随诊观察2年。结果部分活髓切断组的成功率为93.7%,间接盖髓组的成功率为80.0%,两组成功率比较差异无统计学意义(P>0.05)。结论采用部分活髓切断术治疗冠折近髓的年轻恒前牙可能较间接盖髓术更有优势。     

恒前牙冠折露髓部分切髓术的疗效分析

目的：观察恒前牙冠折露髓部分切髓术的疗效。方法：选择26例31牙外伤冠折不超过72h的恒前牙,进行部分冠髓切除术。分别于术后15d、1个月、3个月、6个月、1年、2年进行临床和X线检查。结果：成功29牙,失败2牙,成功率93．5％。失败原因为根管内吸收和暂补料脱落再感染。结论：冠髓部分切除术较根管口部分活髓切断术有许多优点,是一种良好的治疗方法。临床上需严格掌握适应证和操作规程,以提高成功率。     

儿童恒前牙冠折后牙髓活力的保存方法

目的：探讨儿童恒前牙冠折后不同受损程度牙髓活力的保存方法。方法：采用三种方法对不同受损程度的72例98个冠折恒前牙牙髓进行处理，并定期复查。结果：对14个单纯性釉质折断牙牙髓随访2年，牙髓活力不受影响；对23个牙本质折断但未露髓患牙护髓后2年成功率为82.6%，对61个牙本质折断并露髓患牙采取活髓切断术，其2年成功率为81.9%。结论：对损伤程度不同的冠折牙牙髓应采取不同的治疗方法；活髓切除术不仅适用于年轻恒牙，对于牙根已形成但仍处于儿童暑期的恒前牙同样适用；牙本质桥的形成并不意味其下方的牙髓组织正常。     

年轻恒前牙冠折露髓部分活髓切断术的疗效分析

目的观察部分活髓切断术治疗年轻恒前牙外伤冠折露髓的疗效,分析影响疗效的因素。方法对40例45颗因外伤引起的儿童恒前牙冠折露髓的病例应用部分活髓切断术进行治疗,并定期观察。结果应用部分活髓切断术治疗年轻恒前牙冠折露髓,其成功率可达88.9%。结论部分活髓切断术是治疗年轻恒前牙外伤冠折露髓的有效方法,露髓孔的大小及露髓时间的长短对疗效的影响并无显著性。     

年轻恒前牙2类和3类牙折改良间接和直接盖髓术初探

目的：进行无症状年轻恒前牙Ellis 2类牙折和3类牙折保髓治疗新方法的初步探讨。方法：采用改良间接和直接盖髓术--即刻Vitapex间接或直接护髓和树脂冠修复的方法,对35颗外伤冠折的年轻恒前牙进行完整牙髓的保存治疗,并定期复查。结果：35颗外伤上前牙,在最长两年的观察期内,有3例出现慢性牙髓炎的临床表现,失败率为8.6%,其中Ellis 2类牙折2例,3类牙折1例,3例失败病例的根端形态均为根管壁内聚状。有4例出现树脂冠松动或脱落,占11.4%,其中Ellis 2类牙折1例,3类牙折3例。结论：根端形态是判断年轻恒牙外伤后牙髓有无恢复可能的主要因素。采用Vitapex护髓、制作简单并且对儿童牙颌发育影响小的树脂冠来增加固位,技术要求低,为冠折年轻恒前牙保留完整牙髓提供了一种新方法。     

Treatment of crown fractures with pulp exposure in primary incisors

The treatment options of enamel dentin crown fractures with pulpal exposure in the primary dentition traditionally consist of direct pulp capping, pulpotomy, pulpectomy, or extraction. Many clinicians disagree on the most appropriate treatment, and individual preferences exist within dentistry. Partial pulpotomy, also known as the Cvek pulpotomy, is a mode of treatment which is widely used in the permanent dentition but less so in primary teeth. This conservative technique is described and its advantages over the others are presented. In addition, a report of a case with a 2-year follow-up is also included. The purposes of this article are: (1) to present the indications and contraindications of the various treatment modalities for primary incisors with complicated crown fractures; and (2) to suggest partial pulpotomy as a conservative and more appropriate approach for primary incisors with complicated crown fracture.     

Long-term follow-up of a complicated crown fracture treated by partial pulpotomy

AIM: To present the 7-year follow-up of a permanent incisor with complicated crown fracture, treated by partial pulpotomy. SUMMARY: A healthy permanent right central maxillary incisor with complicated crown fracture was treated by partial pulpotomy and reviewed clinically and radiographically for 7 years. At each recall, there was no spontaneous pain; the pulp showed signs of vitality and no periapical radiolucency developed. KEY LEARNING POINTS: Partial pulpotomy may be a successful permanent treatment in cases of complicated crown fracture.     

Endodontic treatment of primary teeth

Endodontic treatment of primary teeth is undertaken by indirect pulp capping, direct pulp capping, formocresol pulpotomy and pulpectomy. The same treatment principles apply to both primary and permanent teeth with infected or necrotic pulps. The main differences are the use of formocresol for root canal medication and a resorbably zinc-oxide and eugenol paste for root canal obturation.     

A retrospective study of treatment provided in the primary and secondary care services for children attending a dental hospital following complicated crown fracture in the permanent dentition

Objectives . To investigate treatment provision in primary and secondary dental care following complicated crown fracture of permanent teeth.
Design and methods. Retrospective observational survey of dental records of all patients attending a dental hospital trauma clinic during a 2-year period with complicated crown fracture.
Results. Eighty children (70% male) aged 6–16 years (mean age 10·3 years) with 98 complicated crown fractures were identified. Of these children, 54% were seen for emergency treatment on the day of their injury, 75% within 48 h. Of the 98 injured teeth, 60% were seen initially in general dental practice but only 56% of these 59 cases were provided with emergency treatment in practice, the others being referred immediately to the trauma clinic for treatment. The main cause of fractures was transport, in particular, bicycles. Radiographs were available for 96 teeth; for the 43 open apex teeth, the definitive treatment was pulp capping (44% of cases) and pulpotomy (30%), with vitality maintained in five cases up to 4·8 years after trauma. The 53 closed apex cases were treated definitively with pulp capping (38%) and pulpectomy (36%) and six teeth had maintained their vitality up to 4·3 years after trauma. Sixty-seven per cent of the pulp caps and 47% of the 19 pulpotomies provided relied on a doubtful coronal seal. This was primarily due to the extensive use of a conventional glass ionomer cement as an emergency bandage. The use of an etched or bonded material at initial presentation extended the Median Survival Time for vitality in open apex teeth from 188 to 377 days and in closed apex teeth from 15 to 64 days.
Conclusions . Emergency treatment of complicated crown fractures, particularly in primary care services is often inappropriate or inadequate with regard to emergency management of the exposed pulp and provision of a hermetic coronal seal.