儿童恒牙全脱出牙周组织预后的回顾性研究

目的：对儿童恒牙全脱出后再植的病例进行回顾性研究，观察再植牙的牙周组织预后类型和各类根吸收出现的时间，分析影响再植牙牙周组织预后的可能因素。方法：对2000年至2012年在北京大学口腔医院就诊的儿童恒牙全脱出系统病历进行回顾性研究，要求观察期大于12个月，记录再植牙的预后和各类牙根吸收出现的时间，分析影响再植牙预后的相关因素，并进行统计学分析。结果：牙周膜愈合率为23.0%，替代性吸收发生率为72.1%，通过临床检查诊断替代性吸收的时间早于影像学检查，86.0%（40/47）的根吸收在再植后1年之内出现。保存在良好储存液中（例如牛奶、生理盐水、唾液等）的全脱出牙齿发生牙周膜愈合的比例显著高于干燥保存和保存在自来水、酒精等不良介质中的牙齿（P＜0.05）。尖牙和前磨牙发生牙周膜愈合的比例最高，其次为下颌切牙；上颌切牙发生牙根吸收的比例最高。结论：再植牙的保存方式与牙周组织预后有显著相关性。最常见的牙周组织预后方式是替代性吸收，诊断替代性吸收应结合临床表现和影像学检查，牙齿再植后的观察期至少应在1年以上。

Retrospective study about periodontal ligament healing of replanted permanent teeth in children

Objective:To analyze the prognosis about periodontal ligament healing of replanted perma-nent teeth in children and to examine the associated factors.Methods: The sample consisted of 49 children with 61 avulsed permanent teeth, whose injuries had been managed in the period from 2000 to 2012.The clinical data of replanted teeth were collected, and the follow-up period was no less than 12 months .The factors were analyzed in relation to postoperative outcomes, classified as functional periodon-tal healing ( FH ) , infection-related ( inflammatory ) resorption ( IRR ) and replacement resorption ( RR) .Results:The functional healing rate was 23.0%, while replacement resorption rate was 72.1%. The replacement resorption ( ankylosis ) was usually observed earlier by clinical examination than by radiographic examination.86.0% (40/47) resorptive processes were diagnosed within the first year. Physiological storages, such as milk, saline and saliva were significantly better to periodontal ligament healing than nonphysiological storages, such as tap water and sterilizing solutions ( chloramine and alco-hol) .Functional healing was found significantly more frequent in canines and premolars.Conclusion:The factor significantly affecting periodontal ligament healing is storage medium.Replacement resorption is the most common type of root resorption.The replacement resorption diagnosis must combine the radio-graphic examination with the clinical examination.It is better to follow up more than 1 year after tooth re-plantation.