Department of General Dentistry and Integrated Emergency Dental Care, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
Dent Traumatol. 2021 Jun;37(3):440-446. doi: 10.1111/edt.12651. Epub 2021 Jan 7.
BACKGROUND/AIMS: Decoronation offers one of the best and most predictable clinical outcomes for dentoalveolar ankylosis. The aim of this study was to determine the factors associated with the efficacy and psychological impact of decoronation for bone preservation.
The study included 42 paediatric patients with 42 infrapositioned replanted permanent teeth. Twelve of these teeth were decoronated. Variables such as the time of injury, stage of root development and the extent of infraposition were analysed. The vertical changes in the alveolar bone level of the decoronated teeth were assessed on radiographs using a three-point scoring system. Parents of 30 patients with teeth that were not decoronated completed a questionnaire addressing their considerations and concerns regarding the treatment of infraposition.
Teeth with root development in stages 2 and 3 showed a significantly higher rate of severe infraposition during the follow-up visits. Decoronation was performed on 12 teeth within 1.5-5 years (mean 3.8 ± 1.3 years) after replantation and 11 of these cases developed a considerable alveolar bone level. The alveolar bone levels of boys and girls showed improvements of 2.2 and 3.2 mm, respectively. The optimal age for decoronation to have a considerable increase in bone level was 12.12 ± 0.83 years for boys and 11.25 ± 1.77 years for girls. Complicated treatments, followed by parents' lack knowledge regarding decoronation, children's fear, follow-up times, and cost were the major concerns regarding decoronation.
The optimal time for decoronation should be decided after considering the age, gender, skeletal growth pattern, and the degree of infraposition at the time of decoronation.
背景/目的：去冠术是治疗牙槽骨粘连的最佳方法之一，可获得最可预测的临床效果。本研究旨在确定与去冠术保骨疗效和心理影响相关的因素。
本研究纳入了 42 名患有 42 颗低位再植恒牙的儿童患者，其中 12 颗牙齿进行了去冠术。分析了受伤时间、牙根发育阶段和低位程度等变量。通过三点评分系统，使用放射影像评估去冠牙牙槽骨水平的垂直变化。未进行去冠术的 30 名患者的家长填写了一份调查问卷，内容涉及他们对低位牙治疗的考虑和担忧。
牙根发育处于 2 期和 3 期的牙齿在随访期间出现严重低位的比例显著更高。去冠术在再植后 1.5-5 年（平均 3.8±1.3 年）进行，其中 11 例出现了可观的牙槽骨水平增加。男孩和女孩的牙槽骨水平分别改善了 2.2mm 和 3.2mm。男孩去冠术增加骨量的最佳年龄为 12.12±0.83 岁，女孩为 11.25±1.77 岁。复杂的治疗、父母对去冠术缺乏了解、孩子的恐惧、随访时间和费用是家长对去冠术的主要担忧。
应在考虑去冠术时的年龄、性别、骨骼生长模式和去冠术时的低位程度后，决定去冠术的最佳时机。
