Wriedt Susanne, Martin Monika, Al-Nawas Bilal, Wehrbein Heiner
Department of Orthodontics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
J Orofac Orthop. 2010 Sep;71(5):318-29. doi: 10.1007/s00056-010-9940-z. Epub 2010 Oct 21.
The purpose of this study was to investigate the incidence of dentoalveolar growth disturbances, loss of teeth and esthetic impairment after the end of growth following traumatic injuries to incisors and periodontal tissues during childhood.
41 patients having sustained dentoalveolar trauma before age 10 and who were now at least aged 16 years, and a total of 68 traumatized teeth were documented by clinical examination, dental casts and photographs. We determined the three-dimensional position of the traumatized teeth on the casts, as well as the traumatized teeth's pulp sensibility, percussive sound and sensitivity, shape and color.
82% of the traumatized teeth were in the upper dentition. 45% of the traumatized teeth experienced subluxation, nearly 30% luxation, 16% avulsion. At the time of the follow-up examination (mean 17.0 years post-trauma), 57% of the traumatized teeth were still in situ. Immediately after trauma 7.4% of the teeth were lost; up to 16 years post-trauma 35.6% of the teeth were lost because of failed root canal filling, root resorption or ankylosis. We observed no functional deviations. Dentoalveolar growth disturbances were rare. Three teeth were markedly discolored.
Following dentoalveolar trauma during childhood, negative effects on growth, function and esthetics can be minimized by timely interdisciplinary treatment and by follow-up controls until the end of growth to achieve an outcome satisfying both the patient and clinician.
本研究旨在调查儿童期门牙及牙周组织遭受创伤后生长结束时牙槽骨生长紊乱、牙齿缺失及美观受损的发生率。
41例在10岁前遭受牙槽骨创伤且目前至少16岁的患者，共68颗创伤牙通过临床检查、石膏模型及照片记录。我们确定了石膏模型上创伤牙的三维位置，以及创伤牙的牙髓敏感性、叩诊音和敏感度、形状及颜色。
82%的创伤牙位于上颌牙列。45%的创伤牙发生了牙震荡，近30%发生了牙脱位，16%发生了牙脱臼。在随访检查时（创伤后平均17.0年），57%的创伤牙仍在原位。创伤后即刻7.4%的牙齿缺失；创伤后16年时，35.6%的牙齿因根管充填失败、牙根吸收或牙根粘连而缺失。我们未观察到功能偏差。牙槽骨生长紊乱罕见。三颗牙齿明显变色。
儿童期牙槽骨创伤后，通过及时的多学科治疗及生长结束前的随访控制，可将对生长、功能及美观的负面影响降至最低，从而实现让患者和临床医生都满意的结果。
