恒牙震荡和半脱位损伤后牙周愈合并发症的纵向队列研究。
Periodontal healing complications following concussion and subluxation injuries in the permanent dentition: a longitudinal cohort study.
机构信息
Pediatric Dentistry and Clinical Genetics, Faculty of Health Sciences, School of Dentistry, University of Copenhagen, Copenhagen, Denmark.
出版信息
Dent Traumatol. 2012 Oct;28(5):386-93. doi: 10.1111/j.1600-9657.2012.01165.x. Epub 2012 Jul 16.
PURPOSE
The purpose of the study was to analyze the risk of periodontal ligament (PDL) healing complications following concussion and subluxation injuries in the permanent dentition.
MATERIAL AND METHOD
A total 469 permanent teeth (358 patients) with concussion and 404 permanent teeth with subluxation were included in the study. All teeth were examined according to a standardized protocol including clinical, photographic, and radiographic registration.
STATISTICS
The risk of repair-related resorption (surface resorption), infection-related resorption (inflammatory resorption), replacement-related resorption (ankylosis), marginal bone loss, and tooth loss were analyzed with the Kaplan-Meier method.
RESULTS
Concussion: In teeth with immature root development, no healing complications were observed. For teeth with mature root development, the risk of repair related resorption after 3 years was 3.2% (95% CI: 0.3-6.0%) and occurred only in cases where several teeth were injured simultaneously (multiple-trauma cases). The risk of marginal bone loss in teeth with mature root development was 0.7% (95% CI: 0-1.6%). Infection-related resorption, replacement resorption, and tooth loss were not observed among teeth with concussion. Subluxation: In teeth with immature root development, the risk of infection-related resorption after 3 years was 1.7% [95% confidence interval (CI): 0-3.8%]. Infection-related resorption occurred significantly more often in teeth with concomitant crown fracture (P = 0.004). For teeth with mature root development, the risk of periodontal healing complications after 3 years was: repair-related resorption, 3.6% (95% CI: 0-7.6%); infection-related resorption, 0.6% (95% CI: 0-1.7%); replacement-related resorption, 0.6% (95% CI: 0-1.7%); and marginal bone loss, 0.6% (95% CI: 0-1.7%). No teeth were lost in the observation period.
CONCLUSION
The risk of periodontal healing complications after concussion as well as subluxation injuries in permanent teeth is very low.
目的
本研究旨在分析恒牙震荡和半脱位损伤后牙周韧带（PDL）愈合并发症的风险。
材料和方法
共纳入 358 名患者的 358 例 358 颗恒牙震荡和 404 例恒牙半脱位患者。所有牙齿均按照标准化方案进行临床、摄影和放射学登记检查。
统计学
采用 Kaplan-Meier 法分析修复相关吸收（表面吸收）、感染相关吸收（炎症吸收）、替代相关吸收（骨粘连）、边缘骨丧失和牙齿缺失的风险。
结果
震荡：在未成熟根发育的牙齿中，未观察到愈合并发症。在成熟根发育的牙齿中，3 年后修复相关吸收的风险为 3.2%（95%CI：0.3-6.0%），仅发生在同时有多个牙齿受伤的情况下（多发伤病例）。成熟根发育牙齿的边缘骨丧失风险为 0.7%（95%CI：0-1.6%）。震荡牙齿未观察到感染相关吸收、替代吸收和牙齿缺失。半脱位：在未成熟根发育的牙齿中，3 年后感染相关吸收的风险为 1.7%[95%置信区间（CI）：0-3.8%]。伴有冠折的牙齿感染相关吸收的发生率明显更高（P=0.004）。成熟根发育的牙齿，3 年后牙周愈合并发症的风险为：修复相关吸收 3.6%（95%CI：0-7.6%）；感染相关吸收 0.6%（95%CI：0-1.7%）；替代相关吸收 0.6%（95%CI：0-1.7%）；边缘骨丧失 0.6%（95%CI：0-1.7%）。观察期内无牙齿缺失。
结论
恒牙震荡和半脱位损伤后牙周愈合并发症的风险非常低。
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