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正畸治疗建议及牙外伤史患者的预期不良反应:普通牙医、儿童牙医和正畸专家的调查。

Orthodontic treatment recommendation and expected adverse reactions in patients with a history of dental trauma: A survey among general dentists, paediatric dentists, and orthodontic specialists.

机构信息

Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.

University Hospitals Leuven, Leuven, Belgium.

出版信息

Int J Paediatr Dent. 2020 May;30(3):360-369. doi: 10.1111/ipd.12603. Epub 2019 Dec 22.

Abstract

BACKGROUND

Trauma-induced adverse reactions may trigger complications when moving teeth orthodontically.

AIM

The purpose of this study was to evaluate the knowledge of dental practitioners about this topic.

DESIGN

A questionnaire survey was organized among general dentists, paediatric dentists, and orthodontists in Flanders (Belgium). Three clinical cases describing trauma-induced tooth damage (tooth ankylosis, apical root resorption, and pulp/root canal obliteration) were presented, followed by a set of questions.

RESULTS

The questionnaire was completed by 121 general dentists (GD), 47 paediatric dentists (PD), and 99 orthodontic specialists (OS). In the case with ankylosis, impossibility to move the tooth orthodontically was reported as most frequent adverse reaction (82.8% of GD, 95.7% of PD, and 100.0% of OS) (P < .001). In the situation of apical root resorption, the most frequently reported adverse event was progressive apical root resorption (78.9%, 85.7%, and 88.8% respectively; P = .265). Most frequently mentioned adverse reaction in the case with pulp and root canal obliteration was tooth discoloration (64.1%, 57.1%, and 78.3%; P = .055), followed by apical root resorption (57.4%, 56.8%, and 68.7%; P = .283). Orthodontic treatment recommendation differed among specific clinical situations but also among groups of dental practitioners.

CONCLUSIONS

Important knowledge gaps exist regarding the orthodontic managment of traumatized teeth. This topic requires more attention in undergraduate training, specialist training, and continuing education.

摘要

背景

创伤引起的不良反应可能在正畸移动牙齿时引发并发症。

目的

本研究旨在评估牙科医生对此主题的认知。

设计

在佛兰德(比利时)组织了普通牙医、儿科牙医和正畸医生的问卷调查。介绍了三个描述创伤性牙齿损伤的临床病例(牙骨粘连、根尖根吸收和牙髓/根管闭塞),随后提出了一系列问题。

结果

共有 121 名普通牙医(GD)、47 名儿科牙医(PD)和 99 名正畸专家(OS)完成了问卷。在牙骨粘连的病例中,无法进行正畸移动被报告为最常见的不良反应(82.8%的 GD、95.7%的 PD 和 100.0%的 OS)(P<.001)。在根尖根吸收的情况下,最常报告的不良事件是进行性根尖根吸收(分别为 78.9%、85.7%和 88.8%;P=.265)。牙髓和根管闭塞病例中最常提到的不良反应是牙齿变色(64.1%、57.1%和 78.3%;P=.055),其次是根尖根吸收(57.4%、56.8%和 68.7%;P=.283)。在特定临床情况下,正畸治疗建议存在差异,而且在牙医群体之间也存在差异。

结论

在创伤后牙齿的正畸管理方面存在重要的知识差距。这个主题需要在本科培训、专科培训和继续教育中得到更多关注。

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