Hayashi Mikako, Kinomoto Yoshifumi, Takeshige Fumio, Ebisu Shigeyuki
Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Suita, Japan.
J Endod. 2004 Mar;30(3):145-8. doi: 10.1097/00004770-200403000-00005.
There is no particular treatment established to preserve vertically fractured teeth. We evaluated the long-term prognosis of the intentional replantation of 26 vertically fractured roots after reconstruction with 4-META/MMA-TBB dentin-bonded resin. Replanted teeth were evaluated according to clinical criteria and radiographic examinations for periods ranging from 4 to 76 months. Eighteen cases were functional and retained, with six fully successful; the others needed further observation. Eight cases failed to respond to treatment because of refracture, recurrence of gingival inflammation, or both. Longevity was calculated as 88.5% at 12 months after replantation, 69.2% at 36 months, and 59.3% at 60 months. All failures occurred in premolar and molar teeth. Longitudinal fractures extending more than 2/3 from the cervical portion toward the apex showed significantly shorter longevity compared with fractures within the 2/3 area (log-rank test, p = 0.02). Intentional replantation of vertically fractured roots reconstructed with dentin-bonded resin may be considered for incisors as an alternative to extraction, although the long-term success is not optimal.
目前尚无专门用于保存垂直根折牙的治疗方法。我们评估了26颗垂直根折牙在用4-META/MMA-TBB牙本质粘结树脂重建后进行即刻再植的长期预后。根据临床标准和影像学检查对再植牙进行了4至76个月的评估。18例功能良好且牙得以保留，其中6例完全成功；其余病例需要进一步观察。8例因再折、牙龈炎症复发或两者兼有而治疗失败。再植后12个月的存留率为88.5%，36个月时为69.2%，60个月时为59.3%。所有失败病例均发生在前磨牙和磨牙。与位于2/3区域内的骨折相比，从颈部向根尖延伸超过2/3的纵向骨折的存留时间明显更短（对数秩检验，p = 0.02）。对于切牙，在用牙本质粘结树脂重建后即刻再植可作为拔牙的替代方法考虑，尽管长期成功率并不理想。
