Ling Kwok K, Ho Christopher T C, Kravchuk Olena, Olive Richard J
School of Dentistry, University of Queensland and Specialist Practice, Brisbane, Australia.
Aust Orthod J. 2007 May;23(1):1-7.
Inferior periodontal and pulpal outcomes may follow surgical exposure of palatally impacted maxillary canines.
To compare the periodontal and pulpal health of palatally impacted maxillary canines following either surgical exposure and assisted eruption (SE) or unassisted eruption following extraction of the overlying deciduous canine and orthodontic creation of space in the arch (OT).
Twenty-eight subjects (OT group: N = 14; SE group: N = 14) with unilateral palatally impacted canines were examined at least six months after orthodontic treatment. The gingival index score, plaque index score, pocket depth, attachment loss, tenderness to percussion, pulpal responses to stimuli and radiographic assessment of changes in the pulpal cavities and peri-radicular areas were collected on the maxillary canines, lateral incisors and premolars. The contralateral teeth were used as controls.
There were no significant differences in the plaque index scores, the gingival index scores or the periodontal outcomes between the impacted canines in the two groups (SE and OT). More impacted canines than control canines had lost some periodontal attachment in the SE group (p = 0.004). Although more lateral incisors, canines and premolars on the impacted side had partially obliterated pulps than the corresponding teeth on the control side, the teeth in both groups had similar pulpal responses (p = 0.064).
Natural eruption and conservative surgical exposure with orthodontic alignment have minor effects on the periodontium. Impacted canines treated surgically and non-surgically had a higher prevalence of pulpal changes than the control canines. Ultimately, the choice of treatment may depend on the clinical indications, the patient's and the orthodontist's preferences.
腭侧埋伏阻生上颌尖牙手术暴露后可能出现牙周和牙髓预后不良。
比较腭侧埋伏阻生上颌尖牙在手术暴露并辅助萌出（SE）或拔除上颌乳尖牙并通过正畸方法在牙弓中开辟间隙后自然萌出（OT）两种情况下的牙周和牙髓健康状况。
对28例单侧腭侧埋伏阻生尖牙患者（OT组：N = 14；SE组：N = 14）在正畸治疗至少6个月后进行检查。收集上颌尖牙、侧切牙和前磨牙的牙龈指数评分、菌斑指数评分、牙周袋深度、附着丧失、叩诊疼痛、牙髓对刺激的反应以及牙髓腔和根尖周区域变化的影像学评估结果。对侧牙齿作为对照。
两组（SE和OT）埋伏阻生尖牙的菌斑指数评分、牙龈指数评分或牙周预后无显著差异。SE组中，埋伏阻生尖牙丧失牙周附着的情况比对照尖牙更多（p = 0.004）。虽然与对照侧相应牙齿相比，患侧更多的侧切牙、尖牙和前磨牙牙髓有部分闭锁，但两组牙齿的牙髓反应相似（p = 0.064）。
自然萌出和正畸排齐的保守手术暴露对牙周组织影响较小。手术和非手术治疗的埋伏阻生尖牙牙髓改变的发生率高于对照尖牙。最终，治疗方法的选择可能取决于临床指征、患者和正畸医生的偏好。
