Division of Periodontology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Dent Traumatol. 2019 Dec;35(6):368-375. doi: 10.1111/edt.12492. Epub 2019 Oct 14.
Teeth are vital sensory organs that contribute to our daily activities of living. Unfortunately, teeth can be lost for several reasons including trauma, caries, and periodontal disease. Although dental trauma injuries and caries are more frequently encountered in a younger population, tooth loss because of periodontal disease occurs in the older population. In the dental implant era, the trend sometimes seems to be to extract compromised teeth and replace them with dental implants. However, the long-term prognosis of teeth might not be comparable with the prognosis of dental implants. Complications, failures, and diseases such as peri-implantitis are not uncommon, and, despite popular belief, implants are not 99% successful. Other treatment options that aim to save compromised or diseased teeth such as endodontic treatment, periodontal treatment, intentional replantation, and autotransplantation should be considered on an individual basis. These treatments have competing success rates to dental implants but, more importantly, retain the natural tooth in the dentition for a longer period of time. These options are important to discuss in detail during treatment planning with patients in order to clarify any misconceptions about teeth and dental implants. In the event a tooth does have to be extracted, procedures such as decoronation and orthodontic extrusion might be useful to preserve hard and soft tissues for future dental implant placement. Regardless of the treatment modality, it is critical that strict maintenance and follow-up protocols are implemented and that treatment planning is ethically responsible and evidence based.
牙齿是重要的感觉器官，有助于我们的日常生活。不幸的是，牙齿可能会因多种原因而缺失，包括外伤、龋齿和牙周病。尽管牙外伤和龋齿在年轻人中更为常见，但由于牙周病导致的牙齿缺失在老年人中更为常见。在种植牙时代，有时似乎倾向于拔除受损的牙齿并用种植牙来替代。然而，牙齿的长期预后可能无法与种植牙的预后相媲美。并发症、失败和疾病（如种植体周围炎）并不罕见，而且，尽管人们普遍认为，种植牙的成功率并非 99%。其他旨在保留受损或患病牙齿的治疗选择，如根管治疗、牙周治疗、有意再植和自体移植，应根据个体情况考虑。这些治疗方法与种植牙的成功率存在竞争，但更重要的是，它们能使天然牙在牙列中保留更长的时间。在与患者进行治疗计划时，详细讨论这些选择很重要，以便澄清有关牙齿和种植牙的任何误解。如果确实需要拔牙，可以采用去冠和正畸牵引等方法来保存软硬组织，以便将来进行种植牙植入。无论采用何种治疗方式，实施严格的维护和随访方案以及制定符合伦理和基于证据的治疗计划至关重要。
