38颗全脱位上颌恒前牙再植临床分析

目的研究38颗全脱位上颌恒前牙再植的临床疗效,探讨影响外伤性全脱位前牙再植术预后的因素。方法33例38颗外伤全脱位上颌恒前牙,清洗后原位再植,复位固定,术后1、3、6、12、24个月定期随访观察,必要时辅以根管治疗等措施。结果38颗全脱位牙再植成功31颗,失败5颗,失访2例,保存率86.11%。结论牙再植的短期临床疗效令人满意。对外伤性全脱位恒前牙再植,应尽量缩短伤后就诊时间、保存于生物相容性介质中;同时必须加强牙再植相关知识的宣教力度。     

50例年轻恒前牙外伤后的治疗

５０例不同程度外伤的年轻恒前牙中，８例用可见光固化复合树脂修复，１７例行活髓切断术，２３例行脱位牙再植术，２例嵌入牙未作处理。经３年以上随访，总成功率为９２％。     

50例年轻恒前牙外伤后的治疗

５０例不同程度外伤的年轻恒前牙中，８例用可见光固化复合树脂修复，１７例行活髓切断术，２３例行脱位牙再植术，２例嵌入牙未作处理。经３年以上随访，总成功率为９２％。     

方丝弓矫治器在恒前牙外伤脱位固定中的应用

目的:评价方丝弓矫治器应用于恒前牙外伤脱位固定的临床疗效.方法:收集37例69颗外伤引起的不伴有牙折的脱位牙.常规口内消毒,复位半脱位牙,避免用暴力强迫完全复位;完全脱位牙及牙槽窝适当处理后,将牙再植,然后应用方丝弓矫治器固定;对于牙根发育完全的嵌入型脱位牙,在弓丝上弯制牵引曲,轻力牵引、复位、固定.半脱位牙固定约2～4周,完全脱位牙固定约4～6周,嵌入型脱位牙或伴牙槽骨骨折的外伤牙可适当延长固定时间,固定约6～8周.结果:经过3a随访观察,69颗外伤牙中,显效32颗,有效35颗,失败2颗,总有效率97.10%.结论:方丝弓矫治器用于恒前牙外伤脱位固定安全简便,临床疗效可靠.     

根尖形成术治疗78例年轻恒前牙外伤的临床效果

根尖形成术（apexogenesis）是采用盖髓术或切髓术使上皮根鞘继续形成牙根，根管变窄，根尖孔缩小的方法。我科门诊收治前牙外伤的78例年轻恒牙，经根尖形成术治疗效果满意，结果报告如下：     

60例年轻恒牙外伤脱位的再植

目的 探讨年轻恒牙外伤脱位再植前处理、牙髓治疗时机、固定方法及固定时间。方法60例完全脱位的年轻恒牙在离体20 min～3h内植入,均未进行牙髓处理,再植后采用正畸托槽及不锈钢片段弓丝固定,固定时间2-3周。结果 60例再植的年轻恒牙中,成功58例,占96.7％;无效2例,占3.3％。成功58例中,显效54例,占90％;有效4例,占6.7％。结论对因外伤导致脱落的年轻恒牙再植成功率高,临床效果好。     

恒前牙牙外伤微创美学治疗技术

前牙创伤发生率占牙外伤的首位,由于所处解剖部位和对美学的影响,其治疗受到医生和患者的高度关注。本文通过对恒前牙牙外伤实施微创美学治疗的重要前提、急诊牙外伤微创美学技术（包括：麻醉、保护性和代偿性治疗、复合树脂修复、根管预备及充填、断冠粘接、牙根牙槽窝移位、正畸牵引、即刻种植、牙齿美白、盖髓术、夹板固定、贴面修复、合并牙周疾病的前牙外伤的处理）以及陈旧性牙外伤的特点和治疗进行综述,为临床施行恒前牙牙外伤的微创美学治疗提供理论和实践依据。     

512例年轻恒前牙外伤的临床分析

本文对１９９０～１９９６年间在北京医科大学口腔医院儿科就诊的５１２名儿童恒前牙外伤的临床资料进行了回顾性调查，分析了儿童恒前牙外伤的类型、外伤原因、受伤方式、伤牙数目、外伤后就诊时间等。结果表明，８～１０岁时牙受伤的人数最多，男女比例为１．９６：１；在各种类型的外伤中，以冠折为最多见；外伤后多在２小时以上，２４小时以内就诊。     

110例儿童恒前牙外伤的临床分析

目的：探讨儿童恒前牙外伤发生的规律以及影响其预后的因素。方法：回顾110例儿童149个外伤恒前牙相关资料，对儿童外伤恒前牙发生原因、年龄、性别、类型、季节等进行分析，对外伤恒前牙就诊时间与其预后的关系加以分析。结果：儿童恒前牙外伤发生的高峰年龄段在8—10岁，受伤原因以跌倒最为多见，最易受伤的牙位是上颌中切牙，以冠折为多见，男性明显高于女性，秋冬季节高于春夏季节．外伤发生后24小时内就诊的年轻恒牙预后较好。结论：儿童恒前牙外伤发生存在一定的规律，外伤后就诊时间是影响外伤牙预后的因素之一。     

方丝弓技术在替牙期恒前牙外伤固定中的应用

目的:分析方丝弓托槽技术和牙弓夹板技术在替牙期恒前牙外伤的临床应用.方法:101 例 193 颗替牙期恒前牙外伤患者,随机分为两组,分别采用方丝弓技术和牙弓夹板技术进行固定.半年后根据患者临床症状及牙周检测指标进行综合评定,并进行统计学分析.结果:两组病人在临床疗效、牙龈指数(GI)、菌斑指数(PLI)上差异有统计学意义(P<0.01).结论:方丝弓技术固定外伤恒前牙的疗效可靠.     

2008年厦门市中小学生恒牙龋病抽样调查分析

目的调查厦门城乡中小学生口腔健康状况,为全国学生体质健康监测网络监测工作的需要以及厦门地区中、小学生恒牙龋病流行趋势及现状提供可靠的数据。方法采用分层整群随机抽样方法,按照《2008年全国学生体质健康监测网络实施方案》中口腔检查的标准,对厦门城乡中、小学生12、14、17年龄组进行口腔健康调查,共1404名学生,其中男性686名,女性718名。采用SPASS 12.0数据软件统计和分析。结果厦门地区中、小学生12、14、17年龄组恒牙总患龋率为48.08%,其中恒牙深龋与浅、中龋构成比率分别为16.53%、83.47%,而充填率仅为15.84%;DMFT总均数为1.38,其中DMFT均数≥1的人数占75.94%,DMFT均数≤3的人数占24.06%。12岁年龄组患龋率为40.16%。结论厦门地区中、小学生恒牙龋病流行趋势较全国其它城市广,其流行程度则较轻。浅、中龋与深龋构成比,浅、中龋是深龋的5倍,DMFT均数≥1是DMFT均数≤3的3倍。第二恒磨牙龋与第一恒磨牙龋构成比随年龄增长而上升。因此,实现龋病预防三早,重视第二恒磨牙开展窝沟封闭具有实际意义。     

Fluoride dentifrice ingestion and fluorosis of the permanent incisors

BACKGROUND: Fluoride dentifrice is a primary means of preventing childhood caries, but it is also an important risk factor for fluorosis. The authors examine the influence of fluoride dentifrice ingestion on fluorosis of the permanent incisors. METHODS: Participants in the Iowa Fluoride Study received questionnaires at regular intervals concerning fluoride sources. The authors assessed fluorosis using the fluorosis risk index. They estimated daily fluoride ingestion from dentifrice, diet and fluoride supplements and divided the amount by kilograms of body weight. The statistical analysis related fluoride ingestion to fluorosis in the permanent incisors. RESULTS: In bivariate analyses, mild fluorosis was significantly related to ingestion of fluoride dentifrice at ages 24 and 36 months (P = .02 for both). After the authors adjusted for fluoride ingested from dietary sources, logistic regression showed a significant association between fluorosis and dentifrice ingestion at age 24 months (P = .04). CONCLUSIONS: The study results suggest that fluorosis of the permanent incisors is influenced by ingestion of fluoride dentifrice during the first three years of life. Further research is needed to assess total intake of fluoride as a risk factor for fluorosis. CLINICAL IMPLICATIONS: These results support recommendations that young children use only a pea-sized amount of dentifrice. Parents should supervise young children as they brush their teeth with fluoride dentifrice.     

Tube-like mineralization in the dental pulp of traumatized primary incisors

Abstract— Mineralization in the pulp is a common finding in permanent as well as primary teeth and is associated with caries, aging, traumatic injuries and systemic conditions. This article describes an unusual pattern of pulpal calcification. A tube-like calcified structure formed in the dental pulp of primary incisors following mild traumatic injuries. It was studied by clinical, radiographic and histologic evaluation and by scanning electron microscopy.
The tube-like structure was found to estend along the entire length of the pulp canal. Generally it was separated from the root dentin by normal pulp tissue, but was connected to the dentin in some sites. It had the histologic appearance of osteodentin with cell inclusions in a ring-like formation that was incomplete in places. The scanning electron microscope study showed rough inner and outer surfaces of a tube-like structure with openings that seemed to be dentinal tubules.     

儿童恒前牙切髓术后根髓组织学研究

目的：牙本质桥的形成是牙髓修复的特征，但至今人们对牙本质桥下方的牙髓组织是否健康仍有争议。本研究目的是观察儿童外伤冠折恒切牙切髓极后根髓的组织学特征，以证实牙髓修复后的牙髓组织变化状况。方法：对16例8－9岁儿童外伤冠折露髓的恒前牙行切髓术，氢氧化钙制剂覆盖牙髓断面，并在牙本质桥形成及根尖发育完成后不同时期行去髓术，将去除的根髓组织固定，常规组织学切片，显微镜观察。结果：术后12－24个月根尖发育完成，此时组织学观察可见牙本质桥下方的根髓组织无明显炎症。至36－48个月，牙髓组织逐渐出现退行性变，例如纤维性变和牙髓钙化等。结论：切髓术后2年内牙本质桥下方的根髓是正常的，而后牙髓逐渐出现退行性变，切髓术可作为儿童前牙冠折露髓的一种暂时治疗方法，当牙根发育完成时，则应采用去髓术。     

Avulsed permanent incisors: knowledge and attitudes of primary school teachers with regard to emergency management

Objectives. This study was designed to examine the knowledge and attitudes of primary school teachers with regard to the emergency management of avulsed permanent incisors. Design. Data were collected by self‐administered questionnaire. Setting. The study was conducted in primary schools lying within a 2‐mile radius of the University Dental Hospital, Cardiff. Sample and methods. A total of 388 teachers in 31 participating schools were asked to complete a questionnaire, which was subsequently collected by two of the authors (CS and AT). Results. Two hundred and seventy‐four teachers returned completed questionnaires, a response rate of 70·6%. One hundred and eighty‐one respondents (60·1%) had received no advice about the emergency management of dental avulsion. Of the 133 teachers (48·5%) who possessed a first aid certificate, 39 (29·3%) had been given relevant advice as part of this training. Less than one‐third of respondents (85 (31%)) cited an optimum extra‐oral time of 30 min or less, with only 43 (15·7%) considering that this should be 10 min or less. However, 125 (45·6%) knew milk to be the best transport medium. Two hundred and four teachers (74·5%) stated that they would not be prepared to replant an avulsed tooth themselves, 133 (80%) basing this decision on lack of expertise and training. Two hundred and sixty‐two teachers (95·6%) expressed a desire for further information. Conclusions. The majority of respondents possessed, at best, rudimentary knowledge of the emergency management of dental avulsion. Teachers, and other individuals who supervise children in schools, should receive simple instruction in dental first aid.     

Parental awareness of the emergency management of avulsed teeth in children

Although public awareness campaigns on avulsed teeth have been mounted in the past, no study has investigated the knowledge parents possess of the protocol for the management of this dental emergency. The purpose of this investigation was to evaluate, by means of a questionnaire, the parental awareness of the emergency management of avulsed teeth in children. Over 2000 parents were surveyed during a four-week period at 20 suburban vacation swimming centres. The results indicated that almost two-thirds of respondents would attempt replantation of an avulsed tooth but further questioning showed they did not know the correct procedures. Thirty-three per cent of respondents were unaware of any after-hours emergency dental services. Ninety-two per cent felt they should seek professional help urgently following an avulsion injury, but their knowledge of transport media for the tooth was poor. Only 5 per cent knew that milk was the medium of choice for both washing and transporting an avulsed tooth. Ninety per cent of parents surveyed had never received advice on what to do in the event of an accident where a permanent tooth was avulsed. This study revealed the need for educational campaigns aimed at parents to increase their knowledge of the emergency procedures required when the tooth is avulsed.     

Survival of avulsed permanent maxillary incisors in children following delayed replantation

Abstract The purpose of this study was to identify the variables that significantly influenced the survival of incisors replanted after extended extraalveolar duration at The Hospital for Sick Children, Toronto, Canada, between June 1988 and December 1993. Survival analysis was used to identify variables that significantly influence the retention of replanted incisor teeth. Survival was defined as the time that elapsed between the replantation of an avulsed incisor and the time it was finally lost. Information on 9 variables was collected for 3H patients (25 males; 13 females) and 52 replanted permanent maxillary incisors. The mean extraalveolar duration for the sample was 123 min. The mean follow-up interval was 942 days (range: 364–2126 days). Incisors replanted with open apices had a significantly decreased survival compared with teeth with mature apices (P=0.04; relative risk 4.2). There was also a significant association between increased survival and obturation of the root canal with gutta-percha and sealer P=0.006 relative risk 10.0). A trend towards improved survival of replanted incisors was found for children older than I 1 years old at the time of replantation (P= 0.09; relative risk 2.8). These results are consistent with previous studies and may assist clinicians and parents in the decision-making process associated with the management of avulsed teeth in children.     

Traumatic injuries of the permanent incisors in children in southern Turkey: a retrospective study

Abstract –  The aim of this study is to investigate the incidence, etiologic factors and results of dental trauma and the effects of age and gender on the trauma in permanent incisors. Over a 3-year period, 514 permanent incisor teeth in 317 patients with trauma history, who applied to Süleyman Demirel University School of Dentistry, Department of Pedodontics from the southern cities of Turkey, were evaluated. Standardized trauma forms were filled for each patient. In all age groups, the most frequent cause of trauma was found to be unspecified falls (47.6%). Maxillary teeth (88.5%) and central incisors (87.5%) were the most affected teeth from dental trauma. Ellis class II crown fracture was the most frequently seen type of injury (43.8%). The percent of the patients who applied to a dental clinic in the first 3 days after the trauma occurred (22.8%) was less than the percent of the patients who applied after 3 months and more time period (45.1%). It reveals that it is important to inform the public about dental trauma and the importance of time in these cases.     

Pulp calcifications in traumatized primary incisors A morphological and inductive analysis study

The purpose of this study was to investigate histopathological changes in primary teeth following trauma, and to look for possible correlations between the morphology of pulpal calcification and clinical findings. The material consisted of 123 primary teeth from 98 Danish children aged 9–108 months (mean age 33.5 ± 19.7 months) at the time of injury. The specimens were analyzed by means of light and scanning and transmission electron microscopy. Data from the clinical investigation and from predetermined ranked parameters from the histological analysis were processed in a computerized inductive analysis program. The results, describing patterns of co-variation, are presented as a decision tree. The most common diagnosis was intrusion luxation (54%). In 41% of all teeth, the degree of obliteration was less than 1/4 of the pulpal lumen. In most cases (79%), no denticles were visible. When present, 80% of the denticles had a bone-like appearance. Tissues occluding the pulpal lumen were either dentin-like (49%). bone-like (19%), or fibrotic (9%). It could be concluded that these varying responses could not be correlated with explicit clinical diagnoses. However, in certain combinations, histological parameters could be correlated to clinical findings.     

A survey of traumatized primary anterior teeth in Jerusalem preschool children

The prevalence of traumatized primary anterior teeth was studied in 965 5-year-olds attending compulsory kindergartens in West Jerusalem in 1971. The prevalence of children with traumatized teeth was 11.1%. No difference between males and females was found. In most cases only one tooth was affected. The tooth most frequently affected was the maxillary central incisor. The most common type of fracture was that of enamel with or without dentin.