Malmgren Barbro
Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Sweden, Stockholm, Sweden.
Pediatr Dent. 2013 Mar-Apr;35(2):164-9.
Dentoalveolar ankylosis of a tooth is a serious complication in growing individuals. The ankylosed root is continuously resorbed and replaced by bone, and an infraposition of the damaged tooth will develop. The normal alveolar development will be disrupted in this way, and prosthetic treatment will be compromised. Therefore, an ankylosed tooth should be removed before future orthodontic and/or prosthetic therapy is jeopardized. This article will present a method, decoronation, to remove an ankylosed tooth in such a way that the alveolar ridge is preserved and give guidelines for the timing to intervene. The decoronation method is described, and a possible explanation for the favorable outcome is discussed. Different aids to decide the time for intervention are presented. The alveolar ridge was maintained in buccal/palatinal direction, and the bone level increased after decoronation in patients treated before or during pubertal growth periods. The bone level also increased in those treated after this period but not at the same rate, and in a few patients it was unchanged. The clinical finding that decoronation can maintain or reestablish normal alveolar conditions is important for successful implant insertion later.
牙齿的牙槽骨粘连是生长发育期个体的一种严重并发症。粘连的牙根会持续被吸收并被骨组织替代，受损牙齿会出现低位萌出。正常的牙槽骨发育会因此受到干扰，修复治疗也会受到影响。因此，在未来正畸和/或修复治疗受到威胁之前，应拔除粘连的牙齿。本文将介绍一种方法——去冠术，即通过该方法拔除粘连牙齿的同时保留牙槽嵴，并给出干预时机的指导原则。文中描述了去冠术，并讨论了取得良好效果的可能原因。还介绍了确定干预时间的不同辅助方法。在青春期生长前或生长期间接受治疗的患者中，去冠术后牙槽嵴在颊侧/腭侧方向得以维持，骨水平有所升高。在此之后接受治疗的患者，骨水平也有所升高，但速率不同，少数患者的骨水平没有变化。去冠术能够维持或重建正常牙槽条件这一临床发现，对于后期成功植入种植体非常重要。
