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上颌恒切牙脱位后延迟再植的后遗症:一项随访24个月的病例系列及临床回顾

Sequelae of delayed replantation of maxillary permanent incisors after avulsion: A case series with 24-month follow-up and clinical review.

作者信息

Hasanuddin Shaik, Reddy J Sharada

机构信息

Department of Pedodontics and Preventive Dentistry, Government Dental College and Hospital, Hyderabad, Telangana, India.

出版信息

J Indian Soc Pedod Prev Dent. 2018 Oct-Dec;36(4):410-416. doi: 10.4103/JISPPD.JISPPD_187_18.

Abstract

Replantation of avulsed incisors in young children is a successful treatment modality. Almost all replanted teeth exhibit ankylosis followed by inflammatory or replacement resorption, as immediate replantation is practically rare. The purpose of the review is to report a series of cases of prolonged delay in replantation of avulsed incisors and discuss its sequelae, leading to different patterns of root resorption after a minimum follow-up period of 24 months. The present case series is a follow-up of five cases of delayed replantation (more than 24 h delay) without any root surface treatment. Extraoral endodontic therapy was performed before replantation. The avulsed teeth were stabilized using an acid-etch composite resin splint for 4 weeks. The patients were followed up at 3, 6, and 12 months interval and half-yearly thereafter, for examination of the replanted teeth clinically and radiographically. After 24-month follow-up, the replanted teeth were evaluated for gingival changes and clinical mobility. The radiographs were evaluated for external root resorption or inflammatory resorption, osseous root replacement, or replacement resorption. The case series concludes that avulsed teeth transported in dry as well as dessicated conditions and replanted after a delay of 24 h have a survival rate of more than 24 months, though there is no promising long-term prognosis. The sequelae in most of the cases are surface resorption followed by inflammatory resorption or resorption due to pulpal infection or replacement resorption.

摘要

幼儿脱出性恒切牙再植是一种成功的治疗方式。几乎所有再植牙都会出现牙根粘连,随后发生炎性吸收或替代性吸收,因为即刻再植实际上很少见。本综述的目的是报告一系列脱出性恒切牙再植延迟时间较长的病例,并讨论其后遗症,这些后遗症在至少24个月的随访期后导致了不同的牙根吸收模式。本病例系列是对5例再植延迟(延迟超过24小时)且未进行任何牙根表面处理的病例的随访。再植前进行了口外根管治疗。使用酸蚀复合树脂夹板将脱出的牙齿固定4周。患者在3、6和12个月时进行随访,此后每半年随访一次,对再植牙进行临床和影像学检查。在24个月的随访后,对再植牙的牙龈变化和临床动度进行评估。对X线片进行评估,以观察牙根外部吸收或炎性吸收、骨质牙根替代或替代性吸收情况。该病例系列得出结论,在干燥及脱水条件下运送并在延迟24小时后再植的脱出牙,其24个月以上的存活率较高,尽管没有良好的长期预后。大多数病例的后遗症是表面吸收,随后是炎性吸收或因牙髓感染导致的吸收或替代性吸收。

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