正畸技术在年轻恒牙嵌入性脱位固定中的应用

目的：比较手法复位与牵引复位在治疗年轻恒牙嵌入性脱位固定中的效果。方法：手法复位＋正畸片段弓固定及牵引复位＋正畸片段弓固定对35例46个嵌入性脱位的年轻恒牙进行固定。结果：两种方法均获得了良好的固定效果,但在活髓保存、根尖诱导成形方面正畸牵引复位更具优势。结论：利用正畸技术复位固定年轻恒牙嵌入性脱位效果肯定,是一种安全、简单、有效的方法。     

年轻恒牙脱位性损伤的诊疗原则

年轻恒牙外伤是影响儿童及青少年牙颌发育与健康的重要疾病,其中脱位性牙外伤常同时累及多颗牙齿和口腔颌面部其他软硬组织,病情复杂,治疗相对困难,远期并发症较多。文章结合2020年国际牙外伤学会颁布的指南,对年轻恒牙脱位性损伤的检查诊断要点、治疗原则和预后进行介绍,为临床儿童牙外伤的诊疗提供参考。     

引导性组织再生术对脱位再植年轻恒牙牙周愈合和牙髓牙根变化的影响

目的观察年轻恒牙脱位后引导性组织再生术(guided tissue regeneration,GTR)对牙周愈合和牙髓牙根变化的影响.方法选择72例144个脱位后无冠折、根折的外伤年轻恒牙,随机分成GTR组和对照组,分别观察牙周愈合和牙髓牙根的变化.结果术后6个月时两组PD均显著减少,附着水平均显著获得,但GTR组探诊深度(probing depth,PD)和附着获得均明显优于对照组.1年时GTR组PD平均减少3.6 mm,附着获得3.5 mm,与对照组2.3 mm、2.2 mm差异十分明显.牙髓坏死率和牙根吸收率两组亦有明显差别(P＜0.01),GTR组各型牙根吸收均明显少于对照组.结论GTR治疗可以提高年轻恒牙外伤后的效果.     

年轻恒牙外伤性脱位的治疗体会

目的　评价外伤脱位年轻恒牙再植的疗效 ,探讨牙再植的方法。方法　按照常规的牙再植术标准步骤 ,对 2 1例脱位的年轻恒牙进行再植。结果　随访 1年 ,再植牙无松动 ,牙龈健康 ,牙槽骨轻度吸收 ,19颗牙牙根继续形成。结论　年轻恒牙再植存活率很高 ,及时就诊 ,妥善处理脱位牙是再植成功的关键。     

年轻恒牙挫入性损伤的处理策略

年轻恒牙挫入性损伤是预后最差的牙外伤类型之一,常导致牙齿缺失,影响患儿的美观及健康.治疗方案通常包括观察再萌出、正畸牵引复位和外科复位3种;临床上应根据患牙的牙根发育情况及挫入程度,参考患儿及家长意愿,选择单独或结合使用上述3种治疗方案进行治疗.治疗后的主要并发症包括牙髓坏死、牙根吸收、牙槽骨边缘性吸收、根管闭塞等.尽...     

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。     

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。     

年轻恒牙完全脱位再植后疗效分析

目的：评价年轻恒牙完全脱位再植后的愈合方式,对不同发育阶段年轻恒牙再植术后的疗效进行总结,为更好保留患牙的美观与功能提供参考。方法回顾分析30颗完全脱位年轻恒前牙,根据国际牙外伤协会治疗指南进行治疗。评价再植后年轻恒牙牙周组织愈合方式,分为牙周膜愈合、表面吸收愈合、替代性吸收（骨粘连）、炎性吸收。结果30颗完全脱位的年轻恒牙再植后,其中7颗为牙周膜愈合,占23.3%;1颗为表面吸收愈合,占3.3％;13颗为替代性吸收,占43.3%;9颗为炎性吸收,占30.0％。结论年轻恒牙发生完全脱位,再植后愈合方式受多种因素影响。当出现不良的愈合方式限制颌面部发育时,一定要及时干预,减少患者生理和心理的创伤。     

恒牙发育的X线研究

目的 确定不同年龄组恒牙钙化的平均值和性别差异,以使恒牙龄能准确评估生理年龄。方法 选择1709例曲面体层片,分别记录每个恒牙的发育度分期值;计算男、女各年龄组恒牙发育度分期值的平均值及总值;绘出恒牙发育值－年龄关系曲线;计算每个恒牙牙冠及牙根发育完成时间。结果 得到4－17岁年龄组恒牙发育度分期的平均值及各年龄组恒牙发育度分期总值及恒牙牙冠及牙根发育完成时间。牙冠发育完成女性比男性平均提前0．3年,平根发育完成女性男性平均提前0．6年。结论 恒牙发育女性早于男性,恒牙发育度分期平均值表可用于评价个体恒牙发育状况。     

187例牙根吸收X线片分析

牙根吸收病因复杂 ,临床典型症状为咀嚼无力 ,牙齿松动 ,X线片表现为牙根不规则吸收 ,本文结合 X线片对 1 87例资料完整的牙根吸收病例进行总结分析其吸收原因 .临床资料1　一般资料 :　自 1 993年以来 ,经拍摄牙片、全景片等确诊为牙根吸收的病例 1 87例 ,计2 0 8枚牙齿 ,病员年龄 1 0～ 70岁 ,男性 90例 ,女性 97例 .2　牙位分布 :　上前牙 6 2枚占 3 0 % ,上双尖牙 1 4枚占 6 .7% ,上磨牙 1 5枚占 7.2 % ,下前牙 1 0枚占 4 .8% ,下双尖牙 2 1枚占 1 0 % ,下磨牙 86枚占 4 1 .3 % .3　与牙根吸收有关的临床情况 :　充填物过高 1 2例 ,不…     

Radiographic and Histologic Evaluation of Experimentally Induced Severe Intrusive Luxation of Immature Teeth in Rats

IntroductionThe aim of this study was to establish an intrusive luxation model in rats and observe the pulpal and periodontal outcomes.MethodsThe intrusion was experimentally induced by an application of 20-N force on the occlusal surface of maxillary right second molar along the tooth axial using a striking instrument in 3-week-old male Sprague-Dawley rats. Thirty rats were divided into 6 groups (n = 5) and were sacrificed after 3, 7, 14, 30, 60, and 90 days of the surgery. The occurrence of pulpal and periodontal complications was observed by micro–computed tomographic scanning and hematoxylin-eosin staining.ResultsAll experimental teeth were fully intruded into the alveolar bone with their occlusal surface located at the cervical level of the adjacent first molar. Spontaneous re-eruption initiated at 7 days. At 14 days, 4 teeth (80%, 4/5) partially re-erupted, whereas 2 (40%), 3 (75%), and 4 (100%) teeth completely re-erupted at 30, 60, and 90 days, respectively. Pulp degeneration and inflammation mainly occurred in 4 teeth at 3 days, 5 at 7 days, and 2 at 14 days; after 14 days, pulp calcification was observed in 8 teeth. Ankylosis and replacement root resorption mainly occurred in 1 tooth at 30 days, 2 teeth at 60 days, and 3 at 90 days. Marginal bone loss was observed in 3 teeth (60%) at 30 days, 3 (75%) at 60 days, and 2 (50%) at 90 days.ConclusionsAn animal model of intrusive dentoalveolar trauma was successfully established in rats. Pulpal and periodontal complications similar to clinical tooth intrusion were observed, which provided a basis for exploring the mechanisms of complications in the future.     

年轻恒牙震荡和移位后牙髓与牙根变化的临床研究

年轻恒牙外伤后,牙髓坏死和牙根吸收在牙齿震荡和牙齿移位中的发生率及发生的时间;牙根的表浅性吸收,置换性吸收,炎症性吸与外伤类型的关系。方法从１９８４－１９９６年在北京医科大学附属口腔医院儿科就诊的２０１例前牙外伤发生牙震荡和牙移位患者的病历资料中选择７９例１５７颗无冠折根折的外伤牙,并且如果有牙松动者使用全牙Ｈｅ     

Treatment Outcomes of Regenerative Endodontic Procedures in Traumatized Immature Permanent Necrotic Teeth: A Retrospective Study

IntroductionThis retrospective study aimed to evaluate the clinical and radiographic outcomes of regenerative endodontic procedures (REPs) for traumatic immature permanent teeth. Meanwhile, predictors influencing treatment outcomes were also analyzed to provide evidence for the management of immature teeth after different traumatic scenarios.MethodsTraumatized immature permanent teeth diagnosed with pulp necrosis treated by REPs using blood clot or concentrated growth factor scaffolds with at least 6 months of follow-up were included from 2012 to 2021. Treatment outcomes were categorized as a success or failure and survival. Further root development was assessed in terms of the percentage changes in the apical diameter, root length, and radiographic root area. Among different injury types, the clinical and radiographic outcomes of REPs were evaluated by the Fisher exact test and the Kruskal-Wallis test, respectively. Survival analysis and Cox regression analysis were performed to identify significant predictors affecting outcomes.ResultsSixty-two teeth with a mean of 22.3 months of follow-up satisfied the criteria, and 80.6% of the teeth had a successful outcome. A significant change was observed in a decrease of the apical diameter (69.3%) and an increase of the radiographic root area (22.6%) after REPs. Among different injury types, the success rates of REPs were as follows: fracture, 84.6%; luxation, 83.3%; combined injuries, 78.6%; and avulsion, 33.3% (P > .05). Fractured teeth had a significantly greater decrease of the apical diameter than combined injuries (P < .05). Avulsion was more prone to developing root resorption than fracture (P < .05). Scaffold was a significant predictor for success; a blood clot had a significantly reduced risk for failure than concentrated growth factor (hazard ratio = 16; 95% confidence interval, 2.1–125.2; P < .001).ConclusionsREPs provided satisfactory outcomes in traumatized immature permanent necrotic teeth. However, severe injuries, especially avulsion, should be determined carefully to perform REPs when resorption is expected. Scaffold selection may be an important consideration.     

Management of Intruded Immature Maxillary Central Incisor with Pulp Necrosis and Severe External Resorption by Regenerative Approach

Introduction

Intrusive luxation is one of the most severe traumatic injuries of permanent teeth that may adversely affect the pulp and the periodontium. Pulp necrosis and root resorption are the main pathologic entities associated with this injury. The present report describes the endodontic management of an intruded immature maxillary central incisor presented with pulp necrosis and severe inflammatory root resorption by using the regenerative approach.

Delayed orthodontic extrusion of a traumatically intruded immature upper permanent incisor – a case report

Dental injuries are probably the most common orofacial injuries sustained during sports and play. Intrusion or intrusive luxations occur when the teeth are driven into the alveolus by an axially directed impact. This article describes the clinical case of an 8‐year‐old patient who suffered complete intrusive luxation of an immature permanent central incisor following an accident. An attempt at spontaneous re‐eruption failed to facilitate re‐emergence of the tooth beyond 2 mm. The recommended wait‐and‐see strategy in anticipation of spontaneous re‐eruption should cease to be an option when no further elongation can be observed. Orthodontic extrusion or surgical re‐positioning is a valid treatment alternative when the former fails. In this case, although the recommended time period for effecting orthodontic extrusion had elapsed, this procedure was undertaken successfully presumably owing to the application of controlled, biologically optimal forces. A review of the extruded tooth a year later revealed no clinical or radiographic signs of loss of vitality. This was confirmed radiographically by the completion of root development, an intact lamina dura and no evident signs of resorption.     

Management of maxillary alveolar bone fracture and severely intruded maxillary central incisor: report of a case

Abstract –  An 11‐year‐old male who injured his maxilla and right maxillary central incisor and lip during a fall was presented to our hospital. His lower lip and upper gingiva were lacerated with swelling and epistaxis, and he had a maxillary alveolar bone fracture and severe intrusion of the right maxillary central incisor, which had penetrated the floor of the nasal cavity with avulsion. Under local anesthesia, we repositioned the incisor and bone segment and fixed them with a titanium micromesh plate and self‐tapping screws and splints. The incisor was also treated by root canal 3 days after the operation and was restored with a crown. We performed root canal filling 1 month later. Five months later, the plate and screws were removed. In prognosis of our case, no symptoms of inflammatory root resorption or ankylosis have observed for more than 1 year and 6 months of follow up based on both clinical and radiographic findings.     

Reinforcement of Simulated Immature Permanent Teeth after Mineral Trioxide Aggregate Apexification

Objectives

The objectives of this study were to compare the fracture resistance of simulated human immature teeth that have undergone mineral trioxide aggregate (MTA) apexification and have been root-filled with fiber post, composite resin, MTA, or gutta-percha.

Long-Term Outcome of Nonvital Immature Permanent Teeth Treated With Apexification and Corono-Radicular Adhesive Restoration: A Case Series

IntroductionThis study aimed to evaluate the long-term outcome of 16 permanent maxillary central incisors with nonvital pulps and open apices treated with apexification and corono-radicular adhesive restorations, within a follow-up span of 5 to 22 years.MethodsFourteen patients providing a total of 16 teeth treated with mineral trioxide aggregate (n = 12), Biodentine (n = 3), or β-tricalcium phosphate (n = 1) apical barrier and corono-radicular restoration, with or without fiberglass post, were included. Clinical and radiographic criteria were defined for assessment at recall. Restoration and periapical tissue status evaluation were performed according to FDI World Dental Federation's esthetic, functional, and biological criteria and Ørstavik Periapical Index (PAI). Outcome was dichotomized as “healed” (PAI ≤ 2, asymptomatic with absence of signs of infection) or “not healed” (PAI ≥ 3, presence of clinical signs and/or symptoms).ResultsFourteen of 24 patients were available for the present study (recall rate = 58%). Within a follow-up of 5 to 22 years, 10 (62.5%) teeth were considered “healed,” fulfilling both strict clinical and radiographic success criteria. Only 1 tooth was missing due to root resorption and 1 patient was presenting with clinical signs and symptoms at recall, resulting in a survival rate of 93.8%.ConclusionsAdhesive corono-radicular restoration in nonvital permanent immature teeth treated with apexification allows for favorable long-term outcomes, by ensuring structural reinforcement and coronal microleakage prevention. Teeth sustaining a substantial loss of coronal structure may require post/core placement. In the case of failure, this endodontic-restorative combination ensured teeth survival until growth phase conclusion, thus allowing for proper prosthetic rehabilitation approaches.