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小儿恒牙切牙脱位的临床预后。II. 牙齿脱出

Clinical outcomes for permanent incisor luxations in a pediatric population. II. Extrusions.

作者信息

Lee Raymond, Barrett Edward J, Kenny David J

机构信息

The Children's Hospital of Western Ontario, London, Canada.

出版信息

Dent Traumatol. 2003 Oct;19(5):274-9. doi: 10.1034/j.1600-9657.2003.00208.x.

DOI:10.1034/j.1600-9657.2003.00208.x
PMID:14708652
Abstract

A longitudinal outcome study was undertaken to identify variables that significantly influenced outcomes for extruded permanent maxillary incisors of children and adolescents. Clinical and radiographic data was available for 35 patients (18 males, 17 females) representing 55 incisors. Mean age at the time of injury was 10.6 years (range: 7.1-17.8 years). Mean time elapsed to follow up was 1320 days (range: 423-2887 days). Survival analysis was used to identify variables significantly related to the prognosis of these teeth. The loss of an incisor following extrusion was uncommon as only one tooth (1/55) required extraction. There was no statistically significant difference in survival between severely extruded teeth and avulsions that had been stored in physiological media (P > 0.10). Pulp necrosis (PN) was the most common complication following injury (43%) and it most often occurred during the first year. Although not statistically significant, a trend towards increased PN was found with more severely extruded teeth (P = 0.20, relative risk = 2.08). Pulp canal obliteration (PCO) was the second most common outcome (35%). The degree of extrusion was proven to be significantly associated with the development of PCO (P = 0.03, relative risk = 0.33). Root resorption was an uncommon outcome (3/55). This study represents the first outcome data on extrusions to permanent maxillary incisors in an exclusively pediatric population.

摘要

进行了一项纵向结局研究,以确定对儿童和青少年上颌恒切牙脱出后结局有显著影响的变量。有35例患者(18例男性,17例女性)共55颗切牙的临床和影像学数据。受伤时的平均年龄为10.6岁(范围:7.1 - 17.8岁)。随访的平均时间为1320天(范围:423 - 2887天)。采用生存分析来确定与这些牙齿预后显著相关的变量。脱出后切牙缺失并不常见,只有一颗牙齿(1/55)需要拔除。严重脱出的牙齿与保存在生理介质中的脱出牙齿在生存率上无统计学显著差异(P > 0.10)。牙髓坏死(PN)是受伤后最常见的并发症(43%),且最常发生在第一年。虽然无统计学显著差异,但发现随着牙齿脱出程度加重,PN有增加趋势(P = 0.20,相对风险 = 2.08)。根管闭锁(PCO)是第二常见的结局(35%)。已证实牙齿脱出程度与PCO的发生显著相关(P = 0.03,相对风险 = 0.33)。牙根吸收是一种不常见的结局(3/55)。本研究是关于仅儿童人群上颌恒切牙脱出的首个结局数据。

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