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[去冠术:因牙外伤导致的牙根粘连性吸收的治疗方案]

[Decoronation: treatment protocol for ankylotic root resorption as a consequence of dental trauma].

作者信息

Lin S, Fuss Z, Wigler R, Karawani M, Ashkenazi M

出版信息

Refuat Hapeh Vehashinayim (1993). 2013 Oct;30(4):32-40, 75.

Abstract

Severe dental traumatic injuries, such as the complete displacement of a tooth from its socket (Avulsion) or the displacement of a tooth within its socket (Intrusive Luxation), may result in extensive injury to the root surface. As a result, the root surface injury heals without cementum and there is fusion between the alveolar bone and the exposed dentin or anorganic exposed cementum, without any attachment apparatus between them. This phenomenon is known as "dento-alveolar ankylosis" and is accompanied by ankylotic resorption of the root. In a process that results subsequent to the ankylosis, the root surface resorbs, and this is part of the remodeling of the alveolar bone (ankylotic resorption). When the traumatic injury occurs at a young age, lateral and apical growth of the alveolar bone continues without continued physiological eruption of the tooth. As a result, the position of the ankylotic tooth does not change, and with time thetooth appears infra-occluded resulting in severe esthetic and functional consequences. Extraction of the ankylotic tooth is difficult and sometimes even impossible due to the rigid fusion between the bone and the tooth. In addition, attempted extraction of the ankylotic tooth may lead to fracture of the buccal plate and resorption of the alveolar bone. Retention of the ankylotic tooth may lead to damage in bone deposition in the verticaldimension, leading to difficulties in future prosthodonticrehabilitation, research-based information has been incorporated

摘要

严重的牙外伤,如牙齿从牙槽窝完全脱位(牙脱臼)或在牙槽窝内移位(嵌入性脱位),可能导致牙根表面广泛损伤。结果,牙根表面损伤在没有牙骨质的情况下愈合,牙槽骨与暴露的牙本质或无有机成分的暴露牙骨质之间发生融合,它们之间没有任何附着装置。这种现象被称为“牙-牙槽骨粘连”,并伴有牙根的粘连性吸收。在粘连之后的一个过程中,牙根表面吸收,这是牙槽骨重塑(粘连性吸收)的一部分。当外伤发生在年轻时,牙槽骨的侧向和根尖生长继续,而牙齿没有持续的生理性萌出。结果,粘连牙齿的位置不变,随着时间的推移,牙齿出现咬合过低,导致严重的美观和功能后果。由于骨与牙齿之间的刚性融合,拔除粘连牙很困难,有时甚至不可能。此外,试图拔除粘连牙可能导致颊板骨折和牙槽骨吸收。保留粘连牙可能导致垂直方向骨沉积受损,导致未来修复假牙困难,已纳入基于研究的信息

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