Stewart C, Dawson M, Phillips J, Shafi I, Kinirons M, Welbury R
Dept Paediatric Dentistry, Cork University Dental School and Hospital, Cork, Ireland.
Eur Arch Paediatr Dent. 2009 Jan;10(1):25-8. doi: 10.1007/BF03262663.
These were to examine the main presenting, treatment and outcome factors for intruded permanent incisors in children, the effect of apical development and degree of intrusion on decisions on repositioning, the effect of apical development status on the maintenance of pulp vitality and the time of pulp extirpation and to compare the decisions made to the advice given in existing clinical guidelines.
A sample of 55 intruded incisor teeth in 40 children aged between 6 and 14 years of age was reviewed in respect of management of their intrusive dental injuries. Of these teeth 17 were intruded in females and 38 in males. Mean (+/-SD) age was 9.3 (+/-1.99) and mean follow-up time was 2.3 years (+/-1.60). Included in the sample were 42 maxillary central incisors and 13 maxillary lateral incisors.
Immature apicies were noted in 34 whilst 21 teeth had mature apices. Clinical and radiographic assessment categorised 4 teeth as mildly intruded with displacement of less than 3 mms; 10 teeth, intruded by 3-6 mm, were considered as moderately intruded whilst a further 11 teeth with intrusion of more than 6 mm were considered to have experienced a severe intrusive injury. There were 19 teeth (35%) that were allowed to re-erupt spontaneously, 22 (40%) were repositioned by orthodontic means and 14 teeth (25%) received surgical repositioning.
There was a statistically significant difference between the repositioning decisions with a more conservative approach for teeth with immature apices (P = 0.0009). Apical completion was a significant predictor of earlier pulp extirpation (p=0.01).
研究儿童恒牙嵌入性损伤的主要临床表现、治疗及预后因素，探讨根尖发育情况和嵌入程度对复位决策的影响，根尖发育状态对牙髓活力维持及牙髓摘除时间的影响，并将所做决策与现有临床指南中的建议进行比较。
对40名年龄在6至14岁之间儿童的55颗嵌入性切牙的侵入性牙损伤处理情况进行回顾性研究。其中女性17颗，男性38颗。平均（±标准差）年龄为9.3（±1.99）岁，平均随访时间为2.3年（±1.60）。样本包括42颗上颌中切牙和13颗上颌侧切牙。
34颗牙齿根尖未发育成熟，21颗牙齿根尖已发育成熟。临床和影像学评估将4颗牙齿归类为轻度嵌入，移位小于3毫米；10颗嵌入3至6毫米的牙齿被认为是中度嵌入，另有11颗嵌入超过6毫米的牙齿被认为遭受了严重的侵入性损伤。19颗牙齿（35%）允许自行再萌出，22颗（40%）通过正畸方法复位，14颗牙齿（25%）接受手术复位。
对于根尖未发育成熟的牙齿，复位决策采用更为保守的方法，两者之间存在统计学显著差异（P = 0.0009）。根尖发育完成是牙髓摘除较早的重要预测因素（p = 0.01）。
