178例儿童埋伏多生牙拔除难度的临床分级

doi:10.19438/j.cjoms.2018.03.013

中国口腔颌面外科杂志 ›› 2018, Vol. 16 ›› Issue (3): 259-262.doi: 10.19438/j.cjoms.2018.03.013

178例儿童埋伏多生牙拔除难度的临床分级

沈燕*，石羽*，周建国，沈海平

浙江嘉兴市协和口腔门诊部，浙江嘉兴314000

收稿日期:2018-01-29 修回日期:2018-03-12 出版日期:2018-05-20 发布日期:2018-06-12
通讯作者: 沈海平，E-mail:shp516@126.com
作者简介:沈燕（1979-），女，学士，主治医师，E-mail：xyqzheng135@163.com；石羽（1981-），男，学士，主治医师，E-mail：shiyu22@163.com。*并列第一作者

Clinical classification of extraction difficulty for embedded multiple teeth in 178 children

SHEN Yan, SHI Yu，ZHOU Jian-guo, SHEN Hai-ping.

Concord Dental Clinic of Jiaxing City. Jiaxing 314000, Zhejiang Province, China

Received:2018-01-29 Revised:2018-03-12 Online:2018-05-20 Published:2018-06-12

摘要/Abstract

摘要： 目的： 探讨儿童埋伏多生牙（embedded and multiple teeth in children，EMTC）的拔除难度及方法。方法： 对178例250颗EMTC进行锥形束CT （cone-beam CT，CBCT）检查,根据埋伏多生牙与恒牙的相邻关系分为3型。I型为多生牙位于恒牙的冠端，Ⅱ型为多生牙位于恒牙的体部，Ⅲ型为多生牙位于恒牙的根端。根据埋伏多生牙牙体形态分为2类。A类，与牙冠-根中轴形成的畸形角度<90°，牙体直形畸形；B类，与牙冠-根中轴形成的畸形角度>90°，牙体钩形畸形。根据各型埋伏多生牙的位置和畸形分类、恒牙的发育状态、拔除难度，选择时机拔除。结果： 拔除难度Ⅰ-Ⅱ级为Ⅰ型、Ⅱ型的A类l76颗，在相邻恒牙尚未完全发育时，作即刻拔除。拔除难度Ⅲ级为Ⅱ型A类12颗、Ⅲ型B类62颗，在相邻恒牙基本发育后，作延期拔除。本组EMTC均完全拔除，无相邻恒牙损伤。结论： 根据EMTC的临床位置分型、牙冠-根畸形的临床分类预测拔牙的手术难度分级，具有一定的临床指导意义。

关键词: 儿童, 埋伏多生牙, 拔牙难度, 分级

Abstract: PURPOSE: To investigate the clinical classification of extration difficulty for embedded multiple teeth in children(EMTC). METHODS: Two hundred and fifty teeth of 178 children with embedded multiple teeth were examined by cone-beam CT(CBCT）. According to the relationship between adjacent embedded multiple teeth and permanent teeth, they were divided into 3 types. Type I:embedded multiple teeth located on the crown of permanent teeth; type Ⅱ: embedded multiple teeth located to the body of permanent teeth; type Ⅲ: embedded multiple teeth located to the root apex of the permanent teeth. The embedded multiple teeth were further divided into 2 classes. Class A: the angle of malformation was<90° with the axis of the crown and root, and the tooth was of straight deformity. Class B: the malformation angle was >90° with the crown-root axis, and the tooth was hook-shaped. The embedded multiple teeth were extracted accordingly based on the different type and class. RESULTS: ：One hundred and seventy-six teeth belonging to type Ⅰ, type Ⅱand class A were removed immediately when the adjacent permanent teeth were not fully developed. Twelve teeth belonging to type Ⅱ, class A, and 62 teeth belonging to type Ⅲ and class B were removed secondly when the adjacent permanent teeth were fully developed. All 250 teeth were removed without damage to the adjacent permanent teeth. CONCLUSIONS: This classification based on teeth morphology is of certain clinical usefulness in predicating extraction difficulty and guidance of operation.

Key words: Children Embedded multiple teeth；Extration difficulty, Classification

中图分类号:

R782.11

沈燕，石羽，周建国，沈海平. 178例儿童埋伏多生牙拔除难度的临床分级[J]. 中国口腔颌面外科杂志, 2018, 16(3): 259-262.

SHEN Yan, SHI Yu，ZHOU Jian-guo, SHEN Hai-ping.. Clinical classification of extraction difficulty for embedded multiple teeth in 178 children[J]. China J Oral Maxillofac Surg, 2018, 16(3): 259-262.

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178例儿童埋伏多生牙拔除难度的临床分级

Clinical classification of extraction difficulty for embedded multiple teeth in 178 children

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