Department of Oral and Maxillofacial Surgery, Medipol University, İstanbul, Turkey.
Dent Traumatol. 2021 Jun;37(3):474-478. doi: 10.1111/edt.12654. Epub 2021 Jan 27.
BACKGROUND/AIM: Maxillo-mandibular fixation (MMF) screws have gained popularity in recent years for inter-maxillary fixation. MMF screw application involves the risk of dental injury. However, knowledge about the healing responses after root damage in humans is limited, thereby warranting the need to classify the radiographic assessment of healing to enable better prediction of the healing response and effective management of the potential complications. The aim of this study was to assess and classify the radiographic assessment of the responses after root damage to evaluate the long-term outcomes.
The dental records of patients who underwent orthognathic surgery or trauma management during 2014-2016 at an Oral and Maxillofacial Surgery Department were retrospectively analyzed. The data regarding dental injuries resulting from MMF screw application were evaluated. In total, 16 patients with 34 roots damaged from MMF screw application were enrolled. Post-operative orthopantomographs were analyzed by visual inspection of the affected areas to clarify the extent of root healing. The inter- and intra-rater reliability assessments were subsequently performed.
The results indicated substantial inter- and intra-rater reliability of the responses. Most cases of root damage that were not radiographically related to the pulp (Schulte-Geers Class III defects) had complete or partial healing responses. In addition, 20% of the defects related to the pulp had additional resorption of the bone/dental tissues during the follow-up period.
Three different radiographic responses of root damage following MMF screw trauma were identified. Understanding these different responses is important to guide the management of the potential complications. This proposed radiographic assessment can be used to present root healing data in a more standardized and reliable manner.
背景/目的：近年来，由于颌间固定的需要，颌骨-下颌骨固定（MMF）螺钉越来越受欢迎。MMF 螺钉的应用涉及到牙齿损伤的风险。然而，关于人类根损伤后的愈合反应的知识有限，因此需要对愈合评估进行分类，以便更好地预测愈合反应并有效管理潜在的并发症。本研究旨在评估和分类根损伤后的影像学评估，以评估长期结果。
回顾性分析 2014 年至 2016 年在口腔颌面外科进行正颌手术或创伤管理的患者的牙科记录。评估了由于 MMF 螺钉应用导致的牙齿损伤的数据。共纳入 16 名患者的 34 个根因 MMF 螺钉应用而受损。通过对受影响区域的影像学检查，分析术后全景片，以明确根愈合的程度。随后进行了组内和组间的可靠性评估。
结果表明，反应的组内和组间可靠性都很高。大多数与牙髓无关的根损伤（Schulte-Geers 类 III 缺损）有完全或部分愈合反应。此外，20%与牙髓相关的缺损在随访期间出现了骨/牙组织的额外吸收。
确定了 MMF 螺钉创伤后根损伤的三种不同影像学反应。了解这些不同的反应对于指导潜在并发症的管理非常重要。这种建议的影像学评估可以用于更标准化和可靠地呈现根愈合数据。
