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[现代恒齿脱出儿童的治疗方法]

[Modern approach to the treatment of children with constant teeth avulsion].

作者信息

Korolenkova M V, Starikova N V, Rakhmanova M S

机构信息

Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia.

出版信息

Stomatologiia (Mosk). 2020;99(6. Vyp. 2):38-43. doi: 10.17116/stomat20209906238.

Abstract

THE AIM OF THE STUDY

Was to analyze treatment outcomes in children with constant teeth avulsion treated in Central Research Institute of Dentistry and Maxillofacial Surgery (CRIDMS).

MATERIALS AND METHODS

The study comprised 39 children aged 7-16 years treated in CRIDMS in 2015-2020. In 38 cases from 39 replantation was performed more than 24 hours after trauma. Because of delayed replantation endodontic treatment was needed in 35 cases from 38 (in one case the avulsed tooth was missing). In all 38 cases replantation was followed by splinting with either resin splint made according to original technique proposed by the authors or semi-flexible splints from orthodontic wire fixed with resin composite.

RESULTS

In one case from 39 the avulsed tooth was missing because a dentist the child first consulted was unaware of the possibility of replantation. In 38 children followed-up for 6-57 months the replanted teeth survived and were clinically asymptomatic. There were, however, obvious radiological signs of replacement resorption in 27 (71.1%) cases. Inflammatory resorption was detected in two cases (5.2%) with immature teeth undergoing apexification with calcium hydroxide.

CONCLUSION

Replacement root resorption after tooth avulsion may be seen as relatively favorable outcome preserving more bone tissue than early tooth removal. The rate of replacement resorption, however, would be less in less delayed replantation. The study results proved the necessity for additional education of parents and pediatric dentists on the first aid and treatment tactics for teeth avulsion.

摘要

研究目的

分析在中央口腔颌面外科研究所(CRIDMS)接受治疗的恒牙脱位儿童的治疗结果。

材料与方法

该研究纳入了2015年至2020年在CRIDMS接受治疗的39名7至16岁儿童。在39例病例中,有38例在创伤后24小时以上进行了再植。由于再植延迟,38例中的35例需要进行牙髓治疗(有1例脱位牙缺失)。在所有38例病例中,再植后均使用作者提出的原始技术制作的树脂夹板或用树脂复合材料固定的正畸钢丝半柔性夹板进行固定。

结果

39例中有1例脱位牙缺失,原因是该儿童最初咨询的牙医不知道再植的可能性。在38名随访6至57个月的儿童中,再植牙存活且临床无症状。然而,在27例(71.1%)病例中有明显的替代性吸收的放射学迹象。在2例(5.2%)正在用氢氧化钙进行根尖诱导成形的未成熟牙齿中检测到炎症性吸收。

结论

牙齿脱位后的替代性牙根吸收可被视为一种相对较好的结果,比早期拔牙保留了更多的骨组织。然而,再植延迟越少,替代性吸收的发生率越低。研究结果证明有必要对家长和儿童牙医进行关于牙齿脱位急救和治疗策略的额外教育。

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