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下颌骨骨折后牙齿敏感性的评估。

Evaluation of sensitivity of teeth after mandibular fractures.

机构信息

Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, School of Dental Medicine, University of Zagreb, Croatia.

出版信息

Int J Oral Maxillofac Surg. 2011 Mar;40(3):266-70. doi: 10.1016/j.ijom.2010.11.016. Epub 2010 Dec 21.

Abstract

The sensitivity of teeth anterior to a fracture between the mental and mandibular foramina has been tested and followed up until reinnervation or 3 years has passed. This study assessed the reinnervation period, the number of denervated teeth, and their clinical importance. Fifty patients and 459 teeth were examined. Two hundred and seventy-three teeth were affected and had potentially impaired innervation. Tests after injury showed non-responsive teeth in 81% of affected teeth. Six weeks after injury, 19% of teeth were reinnervated; by 1 year after injury, 92% of initially non-responsive teeth were reinnervated. Most teeth (34%) were reinnervated from 6 weeks to 3 months. All 23/186 initially non-responsive, unaffected, contralateral corresponding teeth were reinnervated within 6 weeks. A year after injury, 95% of incisors, 91% of canines, 94% of premolars, and 82% of molars were reinnervated. Three years after injury, 8% of teeth remain denervated. During the second and third years, no reinnervation occurred, but clinical signs of pulp devitalisation of denervated teeth occurred in 18% or 1% of the initially non-responsive affected teeth. The results revealed the stability of pulp 1 year after injury. Denervated teeth should not be treated if no clinical or radiological signs of devitalisation exist.

摘要

研究测试并随访了颏孔和下颌孔之间骨折前牙齿的敏感性,直至其重新获得神经支配或 3 年时间过去。本研究评估了神经再支配的时间、去神经化牙齿的数量及其临床意义。共检查了 50 名患者的 459 颗牙齿。273 颗牙齿受到影响并有潜在的神经损伤。受伤后的测试显示,受影响牙齿中有 81%的牙齿无反应。受伤后 6 周,有 19%的牙齿重新获得神经支配;受伤后 1 年,92%的最初无反应的牙齿重新获得神经支配。大多数牙齿(34%)在 6 周到 3 个月之间重新获得神经支配。所有 23/186 颗最初无反应、未受影响、对侧相应牙齿在 6 周内重新获得神经支配。受伤 1 年后,95%的切牙、91%的尖牙、94%的前磨牙和 82%的磨牙重新获得神经支配。受伤 3 年后,仍有 8%的牙齿去神经支配。在第 2 年和第 3 年,没有发生神经再支配,但在最初无反应的受影响牙齿中,有 18%或 1%的牙齿出现牙髓失活的临床迹象。研究结果显示,受伤后 1 年牙髓状态稳定。如果没有牙髓失活的临床或影像学迹象,不应对去神经化的牙齿进行治疗。

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