Werder Peter, von Arx Thomas, Chappuis Vivianne
Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Switzerland.
Schweiz Monatsschr Zahnmed. 2011;121(4):312-20.
To evaluate the treatment outcome of avulsed and replanted permanent incisors.
42 avulsed and replanted permanent incisors in 37 individuals were followed over a median observation period of 2.8 years (range: one year to five years). The mean age was 16.3 years at the time of replantation, with 81% of patients being younger than 20 years.
The tooth survival rate after replantation was 83.3% (35/42 teeth). Periodontal healing was observed in 20 teeth. External root resorption was the most frequent complication and was found in 22 of the 42 avulsed teeth: 21 teeth had replacement resorption. Of these 21 teeth, 14 teeth were still in situ at time of recall examination, seven teeth had to be extracted during the follow-up period due to progressive replacement resorption. One tooth had surface resorption. In contrast, infection-related resorption could not be observed in this sample. With regard to periodontal healing, no differences were found between teeth with short (less than 14 days) versus prolonged duration of splinting. Higher incidence of replacement resorption correlated with the extended duration of non-physiologic extraoral storage.
Use of a strict endodontic treatment protocol after replantation minimized the risk of infection-related root resorption. The occurrence of replacement resorption was mainly influenced by the duration of the non-physiologic extraoral storage time and storage medium.
评估恒牙脱位再植后的治疗效果。
对37例患者的42颗恒牙脱位再植牙进行了随访，中位观察期为2.8年（范围：1年至5年）。再植时的平均年龄为16.3岁，81%的患者年龄小于20岁。
再植后的牙齿存活率为83.3%（42颗牙中的35颗）。20颗牙观察到牙周愈合。外吸收是最常见的并发症，在42颗脱位牙中有22颗出现：21颗牙有替代性吸收。在这21颗牙中，14颗牙在复查时仍在位，7颗牙在随访期间因进行性替代性吸收而不得不拔除。1颗牙有表面吸收。相比之下，本样本中未观察到感染相关性吸收。关于牙周愈合，短时间（少于14天）与长时间固定的牙齿之间未发现差异。替代性吸收的发生率较高与非生理性口外保存时间延长有关。
再植后采用严格的牙髓治疗方案可将感染相关性牙根吸收的风险降至最低。替代性吸收的发生主要受非生理性口外保存时间和保存介质的影响。
