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上颌前磨牙斜行冠折的黏接牙片再植治疗:19 年随访。

Treatment of oblique crown fractures in maxillary premolars using adhesive tooth fragment reattachment: 19 years of follow up.

机构信息

Department of Restorative Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil.

出版信息

Dent Traumatol. 2011 Dec;27(6):455-9. doi: 10.1111/j.1600-9657.2011.01014.x. Epub 2011 May 27.

Abstract

This report presents an oblique crown fracture in the maxillary right premolars of an adolescent because of fall, which was treated using adhesive tooth fragment reattachment. The impact of the mandible base to the floor caused minor fractures in multiple teeth, severe fracture of teeth 14 and 15, and condylar fractures. The fragments of teeth 43, 45, 46, and 16 were lost at the site of accident. The condylar fractures were managed with a non-surgical conservative approach combining mandibular immobilization and stabilization of temporomandibular joints with maxillomandibular fixation using acrylic splints. After 3 months, the interocclusal splints were removed, and the patient was referred for dental care. Teeth 14 and 15 presented complicated oblique crown fractures causing separation of the buccal and palatal fragments, which were in place, attached to the gingival tissue. Tooth 15 presented chronic hyperplastic pulpits. The fragments were banded for stabilization during the endodontic treatment, and the bands served as matrix for adhesive tooth fragment reattachment. The other fractured teeth received direct composite resin restorations. After 8 years, tooth 16 developed pulp necrosis and was treated endodontically and restored with composite resin. Clinical and radiographic examination 19 years after trauma showed a good adaptation of the tooth fragment/composite resin restoration, good periodontal health, no signs of root resorption, and intact lamina dura.

摘要

本报告介绍了一例因跌倒导致上颌右侧前磨牙斜向冠折的青少年病例,采用粘接牙碎片再附着技术进行治疗。下颌骨基底部撞击导致多个牙齿出现轻微骨折、14 号和 15 号牙齿严重骨折和髁突骨折。43、45、46 和 16 号牙齿的碎片在事故现场丢失。髁突骨折采用非手术保守治疗方法,结合下颌骨固定和颞下颌关节稳定,使用丙烯酸夹板进行颌间固定。3 个月后,拆除牙合间夹板,患者转来进行口腔护理。14 号和 15 号牙齿呈现复杂的斜向冠折,导致颊侧和腭侧碎片分离,这些碎片位置良好,附着在牙龈组织上。15 号牙齿呈现慢性增生性牙髓炎。碎片在根管治疗期间用带环固定以稳定,带环作为粘接牙碎片再附着的基质。其他骨折牙齿接受直接复合树脂修复。8 年后,16 号牙齿发生牙髓坏死,接受根管治疗并用复合树脂修复。创伤后 19 年的临床和影像学检查显示,牙碎片/复合树脂修复体适应良好,牙周健康状况良好,无牙根吸收迹象,完整的硬骨板。

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