中国口腔颌面外科杂志 ›› 2021, Vol. 19 ›› Issue (2): 167-172.doi: 10.19438/j.cjoms.2021.02.013

• 临床总结 • 上一篇    下一篇

26例乳牙挫入性外伤后保留患牙的回顾性分析

盛恺, 赖光云, 丁琴*, 汪俊*   

  1. 上海交通大学医学院附属第九人民医院·口腔医学院 儿童口腔科,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011
  • 收稿日期:2020-09-24 修回日期:2020-11-02 出版日期:2021-03-20 发布日期:2021-05-11
  • 通讯作者: 丁琴,E-mail: 13916719616@163.com;汪俊,E-mail: wangjun202@126.com。*共同通信作者
  • 作者简介:盛恺(1988-),男,硕士,E-mail: eskei@sina.com
  • 基金资助:
    上海市卫生健康委员会卫生行业临床研究专项(20194Y0049); 上海交通大学医学院附属第九人民医院种子基金(JYZZ039); 上海交通大学医学院附属第九人民医院临床研究助力计划资助(JYLJ010); 上海交通大学医学院附属第九人民医院护理院基金(JYHL2019MS12)

A retrospective study on the prognosis of retaining injured deciduous teeth after intrusive luxation in 26 cases

SHENG Kai, LAI Guang-yun, DING Qin, WANG Jun   

  1. Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology. Shanghai 200011, China
  • Received:2020-09-24 Revised:2020-11-02 Online:2021-03-20 Published:2021-05-11

摘要: 目的 分析乳牙外伤挫入后保留患牙的预后及影响因素。方法 回顾2018年3月—2019年10月间因乳牙挫入性移位就诊于上海交通大学医学院附属第九人民医院儿童口腔科的病例,根据纳入和排除标准,选择采用保留挫入牙且病史完整可回溯的26例36颗乳牙的病历资料,回顾再萌出情况及牙髓预后,分析其与患儿年龄及挫入程度的相关性。采用SPSS 23.0软件包进行统计学分析。结果 33颗挫入乳牙采用等待观察方案,97%的患牙自发再萌出,其中54.6%完全萌出,42.4%部分萌出,仅有1颗患牙发生固连。随访期内42.4%的患牙发生牙髓坏死、炎性吸收,57.6%无症状和体征。年龄与挫入程度对挫入牙是否再萌出无显著影响,但挫入程度会显著影响牙髓预后(P<0.05)。另有3颗患牙采用手术复位固定,未行预防性牙髓处理,全部发生炎症性外吸收。结论 乳牙外伤挫入后多可自发再萌出,其牙髓预后与挫入程度相关。

关键词: 乳牙, 牙外伤, 挫入伤, 患牙保留, 等待观察, 手术复位

Abstract: PURPOSE: To analyze the prognosis of retaining injured deciduous teeth after intrusion and the related factors to prognosis. METHODS: This was a retrospective study of patients diagnosed as deciduous tooth intrusion treated from March 2018 to October 2019. According to the inclusive and exclusive criteria, the data of 36 intruded teeth from 26 patients were selected. The occurrence of re-eruption and pulp prognosis were recorded, their relevance to the severity of intrusion and patients' age was evaluated. The data was analyzed using SPSS 23.0 software package. RESULTS: There were 33 teeth treated with watchful waiting policy. 97% re-erupted spontaneously, 54.6% re-erupted completely and 42.4% partially re-erupted. Only one tooth developed ankylosis. During the follow-up period, 42.4% of the observed teeth suffered from pulp necrosis/infection related resorption, and the remaining showed no clinical symptoms. No obliteration was observed among the teeth. Age and the degree of intrusion had no significant influence on tooth re-eruption, but the degree of intrusion had significant influence on pulp prognosis(P<0.05). There were 3 teeth treated with surgical reposition, without preventive pulp treatment, external root resorption happened in all these cases. CONCLUSIONS: For deciduous tooth intrusion, re-eruption can be expected in most watchful waiting cases regardless of age and the intrusion severity, while the prognosis of pulp was correlated with the degree of intrusion.

Key words: Deciduous teeth, Traumatic dental injury, Intrusion, Retaining teeth, Watchful waiting policy, Surgical reposition

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