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[牙根外吸收]

[External root resorption].

作者信息

Rathe Florian, Nölken Robert, Deimling Daniela, Ratka-Krüger Petra

机构信息

Abteilung für Zahnerhaltungskunde und Parodontologie, Universität Freiburg, Deutschland.

出版信息

Schweiz Monatsschr Zahnmed. 2006;116(3):245-53.

Abstract

Root resorption may be a physiological (resorption of deciduous teeth) or a pathological process (resorption of permanent teeth). In the latter case an external and an internal form of resorption can be distinguished. Root resorption may occur on one tooth or on several teeth within a dentition and it may be caused by trauma, periodontitis, orthodontic treatment, internal bleaching, cysts, tumors, or by stimuli from a necrotic dental pulp. Current knowledge concerning the pathogenesis of root resorption and therapeutic approaches are presented. For cervical resorption, it is assumed that the stimulus for the resorbing cells originates from the bacteria within the gingival sulcus and along the affected root surface. The case presented here was initially diagnosed as chronic periodontitis of medium severity. Scaling and root planing were performed resulting in a significant improvement of the periodontal status. Two years later, following a period of irregular recall visits, the patient presented with large areas of cervical resorption on teeth 36 and 37 which made it impossible to preserve these teeth. After another six months, teeth 34 and 35 showed deep destruction caused by external root resorption, mandating the extraction of these teeth as well. Fourteen months later, external root resorptions were evident on teeth 32 and 33, and at the same time, a recurrence of the chronic periodontitis was noted. Periodontal therapy was performed under a systemic antibiotic regime. It was possible to preserve teeth 32 and 33 through surgical crown lengthening procedures. No additional resorption has been observed ever since.

摘要

牙根吸收可能是一种生理过程(乳牙吸收)或病理过程(恒牙吸收)。在后一种情况下,可以区分外部吸收和内部吸收两种形式。牙根吸收可能发生在一颗牙齿上,也可能发生在牙列中的多颗牙齿上,其可能由创伤、牙周炎、正畸治疗、内漂白、囊肿、肿瘤或坏死牙髓的刺激引起。本文介绍了有关牙根吸收发病机制和治疗方法的现有知识。对于颈部吸收,推测吸收细胞的刺激源自龈沟内及受影响牙根表面的细菌。此处呈现的病例最初被诊断为中度慢性牙周炎。进行了龈上洁治和根面平整,牙周状况有显著改善。两年后,在一段不定期复诊之后,患者36和37号牙出现大面积颈部吸收,导致无法保留这些牙齿。再过六个月,34和35号牙因外部牙根吸收出现深度破坏,因此也必须拔除。14个月后,32和33号牙出现明显的外部牙根吸收,同时,慢性牙周炎复发。在全身应用抗生素的情况下进行了牙周治疗。通过手术冠延长术得以保留32和33号牙。此后未再观察到额外的吸收情况。

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