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。     

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。     

外伤全脱位牙19小时后再植效果观察

牙齿全脱位,又称牙脱臼(complete avulsion),是指牙周膜完全断裂,牙齿与牙槽骨完全分离,患牙从牙槽窝中脱出[1].一般认为最好在脱臼后2小时内再植,文献报告再植成功的脱位牙最长的离体时间达15天[2].脱位的牙齿应立即冲洗后放入原位,或保存在口腔内舌下、牛奶内或生理盐水中并尽快就医[1].作者接诊一例离体19小时,干燥保存的切牙,再植后14个月临床效果满意,报告如下.     

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...     

42例外伤性脱位牙再植临床疗效分析

目的：探讨脱位牙再植成功的影响因素。方法：42例68个脱位牙经常规处理后原位再植，固定，并进行1年的随访观察。结果；本组42例中再植成功38例60个牙，成功率88．2％。结论：脱位时间短，离体牙保存方法得当，牙根尖孔未发育完成者，以及牙周、牙槽无损伤的病例再植成功率高。     

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目的探讨外伤脱位牙即刻再植的临床疗效及其影响因素。方法选择1993年10月至2005年10月于江西省萍乡市人民医院和广东工业大学医院口腔科就诊的外伤脱位牙患者46例60颗牙进行即刻再植,术后随访观察5年。结果再植牙术后5年成功率为75%,累计有11例15颗再植牙失败,失败原因主要为术后牙根吸收大于根长1/3(占60%)、继发感染(占26.7%)、固定不牢靠(占13.3%)。离体时间<30 min再植牙的牙髓成活率和牙周膜愈合率均高于离体时间>30 min的再植牙,差异有统计学意义(P<0.01)。结论即刻再植外伤脱位牙经适当的临床治疗仍可保留多年,再植成功的关键是严格选择适应证、正确选择离体牙储存介质、尽快植入缩短牙离体时间、尽可能保存牙周膜活性、牢靠的固定结合功能运动和及时有效防治感染。     

严重污染离体牙再植

病例 :患者 ,男 ,1 7岁 ,中学生。于 1 985年 5月玩闹时撞在窗角上致三颗上前牙外伤脱位 ,在个体诊所将三颗牙拔除扔在痰孟里 ,两小时后 ,家长又从痰孟里捡出三颗牙 ,来医院就诊。检查 :112 三颗离体牙 ,11牙体完整 ,2 根折约 2 mm,相应部位牙龈撕裂伤 ,牙槽窝完好 ,无牙槽骨骨折。诊断 :112 外伤性全脱位。处理 :行即期再植术 ,首先用自来水反复冲洗脱位牙至肉眼观洁净为止 ,然后用生理盐水反复冲洗 ,置入加有 8万单位庆大霉素的生理盐水中浸泡 30分钟 ,用氧化锌丁香油糊行根管倒充填。牙槽窝用3%双氧水和 0 .9%生理盐水反复冲洗 ,擦净 ,去…     

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。     

影响老年人前牙外伤性脱位再植成功的相关因素分析

目的:对影响老年人前牙再植成功的各种因素进行分析,以找出规律,指导临床.方法:常规处理脱位牙后,复位固定,随访观察.结果:再植成功率58.4%.离体时间长短、牙周膜创伤程度、牙髓治疗与否、保存方法、对应牙槽骨情况均影响再植成功率.离体时间延长,牙周膜创伤严重,再植成功率呈下降趋势.牙髓治疗后再植成功率高,湿保存方法成功率高,脱位牙对应牙槽骨骨折者成功率低.结论:细心保护脱位牙根面牙周膜、良好固定、预防感染、防止咬合创伤是再植成功的重要因素.     

12例牙根未发育成熟全脱位恒牙再植后疗效评价

目的研究保存牙髓对牙根未发育成熟的全脱位恒牙再植预后的影响。方法选择因外伤来院就诊的全脱位恒牙26颗,干燥保存,离体时间在1h～2h之间。试验组为13颗根尖孔未闭合的年轻恒牙,使用生理盐水冲洗完全脱位牙及牙槽窝,局麻下复位,树脂夹板固定,调(?),2周后拆除固定装置。对照组为13颗根尖已经闭合的恒牙,复位固定一周后进行常规牙髓治疗,Vitapex糊剂充填。6个月后更换一次糊剂。所有病例每三个月拍摄牙片,观察评价牙根吸收程度。随访18个月后。根据牙根是否发生炎症性吸收评价治疗是否成功。采用SPSS13.0软件包对数据进行统计学分析。结果再植后18个月,实验组成功率为46.2%,对照组成功率为84.6%,两组差异具有统计学意义(P<0.05)。结论对于保存条件差,离体时间长的根尖未闭合全脱位恒牙,建议复位固定一周后应采用常规牙髓治疗,充填Vitapex糊剂,以减轻髓腔内及根尖区炎症反应,促进牙本质桥形成,诱导根尖发育。     

Bacteriologic evaluation of the effect of 0.5 percent sodium hypochlorite in endodontic therapy

The antibacterial effect of 0.5 percent sodium hypochlorite solution as root canal irrigant was studied in fifteen single-rooted teeth. Each tooth was treated at five appointments, and the presence of bacteria in the root canal was studied on each occasion. No antibacterial intracanal dressings were used between the appointments. When 0.5 percent hypochlorite was used no bacteria could be recovered from twelve of fifteen root canals at the fifth appointment. This should be compared with eight of fifteen root canals when saline solution was used as irrigant. These results suggest that 0.5 percent sodium hypochlorite solution is more effective than saline solution as a root canal irrigant.     

Influence of irrigation and intracanal dressing on the healing process of dogs' teeth with apical periodontitis.

Dogs' teeth with apical periodontitis were treated endodontically, Dakin's solution being used in an experimental group as the irrigation solution, and camphorated paramonochlorophenol as an intracanal dressing. For a second group of teeth, the irrigation solution used was physiologic saline, dry cotton only being placed into the pulpal chamber to take the place of an intracanal dressing. In a second visit, overinstrumentation and a new application of the same kind of dressing were performed, the root canals being then filled with gutta-percha cones and zinc oxide-eugenol cement. Other specimens were treated, in one visit, where physiologic saline or Dakin's solution were the irrigation solutions. The animals were sacrificed 6 months after the obturation of the root canals. Histologic exams showed better results for the experimental group where Dakin's solution and camphorated paramonochlorophenol had been used, with signs of repair characterized by newly formed cementum and bone tissue, as well as a marked reduction in size of the periapical lesions. No differences were seen in the results with physiologic saline or Dakin's solution as irrigants.     

Viability of fibroblasts in a novel probiotic storage media

Abstract – A number of storage media have been investigated as to their ability to maintain the viability of the periodontal ligament (PDL) cells and thus to permit longer extra‐alveolar periods prior to replantation of avulsed teeth. The aim of the present in vitro study was to evaluate the number of viable PDL cells of avulsed teeth treated by Hank’s Balanced Salt Solutions (HBSS), saline, a novel probiotic solution and milk. Thirty‐six freshly extracted single‐rooted human teeth with closed apices were divided into one of the four experimental groups and two control groups (N = 6 each). The positive and negative controls corresponded to 0 min and an 8‐h dry time respectively. Following extraction, the coronal 3 mm of PDL tissue was scraped with a #15 scalpel to remove cells that might have been damaged. The experimental teeth were dried for 30 min followed by a 45 min immersion in one of the four experimental media. Each experimental tooth, after drying and soaking, was incubated for 30 min with a 2.5 ml solution of 0.2 mg ml^?1 of collagenase CLS II and a 2.4 mg ml^?1 solution of dispase grade II in phosphate buffer saline (PBS). The cells were then labelled with 0.4% Trypan blue for determination of viability. The teeth stored in positive control demonstrated the highest number of viable PDL cells followed in rank order by HBSS, saline, Lactobacillus reuteri solution and milk. There was no significant difference in the number of viable PDL cells between HBSS, milk, L. reuteri solution and saline. Within the parameters of this study, it appears that probiotic may be able to maintain PDL cell viability as HBSS, milk, or saline.     

Effect of brief storage in ATP solution on periodontal healing after replantation of teeth in rats

Abstract ATP solution seems to increase calcium absorption when applied both to dentin and to the pulp before the application of calcium hydroxide. In this study, the effects of a brief storage of teeth in ATP or saline solution before replantation were compared. The right maxillary incisors of 80 male albino rats were extracted and immersed, either directly or after 25 min air-drying, in ATP or saline solution and then replanted. Eight animals in each group were killed 5, 10, 30, 60 and 90 d after replantation and the teeth were examined histologically. The histometric analysis revealed significant differences between the saline- and ATP-treated group. More new cementum or cementum-like tissue was deposited over the radicular surface in the ATP-treated teeth. More root surface area was resorbed and not repaired by new cementum in the saline group and more total root surface was not resorbed or resorbed and repaired in the ATP-treated group. Based on these findings, it seems reasonable to conclude that brief storage of teeth in ATP solution before replantation may have improved the healing of replanted teeth in rats.     

Effect of brief storage in ATP solution on periodontal healing after replantation of teeth in rats

ATP solution seems to increase calcium absorption when applied both to dentin and to the pulp before the application of calcium hydroxide. In this study, the effects of a brief storage of teeth in ATP or saline solution before replantation were compared. The right maxillary incisors of 80 male albino rats were extracted and immersed, either directly or after 25 min air-drying, in ATP or saline solution and then replanted. Eight animals in each group were killed 5, 10, 30, 60 and 90 d after replantation and the teeth were examined histologically. The histometric analysis revealed significant differences between the saline- and ATP-treated group. More new cementum or cementum-like tissue was deposited over the radicular surface in the ATP-treated teeth. More root surface area was resorbed and not repaired by new cementum in the saline group and more total root surface was not resorbed or resorbed and repaired in the ATP-treated group. Based on these findings, it seems reasonable to conclude that brief storage of teeth in ATP solution before replantation may have improved the healing of replanted teeth in rats.     

Influence of irrigation and intracanal dressing on the healing process of dogs' teeth with apical periodontitis

Abstract Dogs’ teeth with apical periodontitis were treated endodontically, Dakin's solution being used in an experimental group as the irrigation solution, and camphorated paramono-chlorophenol as an intracanal dresssing. For a second group of teeth, the irrigation solution used was physiologic saline, dry cotton only being placed into the pulpal chamber to take the place of an intracanal dressing. In a second visit, overinstrumentation and a new application of the same kind of dressing were performed, the root canals being then filled with gutta-percha cones and zinc oxide-eugenol cement. Other specimens were treated, in one visit, where physiologic saline or Dakin's solution were the irrigation solutions. The animals were sacrificed 6 months after the obturation of the root canals. Histologic exams showed better results for the experimental group where Dakin's solution and camphorated paramonochlorophenol had been used, with signs of repair characterized by newly formed cementum and bone tissue, as well as a marked reduction in size of the periapical lesions. No differences were seen in the results with physiologic saline or Dakin's solution as irrigants.     

Effect of storage in recipient's blood on the immunogenicity of tooth allografts in rabbits.

Dental allografts can immunize recipients against skin allografts because some antigens are shared between teeth and skin. The effect of storage in the recipient's blood (ten days, 4 C) on the immunogenicity of subcutaneously allotransplanted rabbit teeth was examined. Storage in blood depressed the antigenicity of teeth, as detected by prolongation of the rejection time of second-set skin grafts in comparison with teeth stored in saline solution, or fresh, nonstored teeth. Further studies are needed to elucidate the mechanism of this procedure.     

The pH changes of four different root canal sealers after mixing at various time intervals in vitro

The purpose of this study was to compare the surface pH level of four different type sealers after mixing at various time intervals in vitro. After cleaning and shaping root canals in 50 recently extracted, single-rooted human teeth, they were divided into six groups. Each of four groups was obturated with Apexit, N2, Sealapex, and Grossman sealers. The remaining groups served as controls. In group 1 nothing was added to the vial of saline solution. In group 2 canals had been instrumented but not obturated with sealer. The pH level of saline solutions was determined at intervals of 1 hour, 4 hours, 1 day, 2 days, 3 days, 1 week, and 4 weeks after teeth were placed in them. The pH levels of the five solutions were compared to each other and to that of saline solution only.     

Correlation between sealer penetration and microleakage following the use of MTAD as a final irrigant

The relationship between sealer penetration and apical microleakage following the use of MTAD as an irrigant in root canal procedures was evaluated. A collection of 120 human teeth was divided into three groups of 40 in each group. The final rinse was varied as follows: group 1 - the final rinse was saline solution, group 2 - ethylene diamine tetraacetic acid and for group 3 - MTAD. Each group was then divided into two subgroups (20 teeth) and filled with gutta percha and either AH Plus or Dorifill sealer. Half of the teeth were selected for dye penetration testing and the sealer penetration in the remaining teeth was evaluated using scanning electron microscope. There were no significant differences between the three irrigants, but there was less dye penetration in teeth sealed with AH Plus than Dorifill. Penetration of the sealer was better in the MTAD and ethylene diamine tetraacetic acid groups than in the saline group. Statistically, there was no significant difference between the sealer penetration into the dentinal tubules and the dye penetration.     

Quantitative evaluation of the influence of dequalinium acetate and sodium hypochlorite on human dentition

The effect of 5 percent DA, 2.5 percent and 5.5 percent sodium hypochlorite, and saline on the solubility of organic matrix of the dentin was studied on extracted human teeth. The results showed that sodium hypochlorite dissolved collagen from the canal walls, while DA did not dissolve any collagen into the media. It is concluded that the root-canal-cleansing effect of DA is achieved by another mechanism, most likely by surface activity.