State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No 14, Section 3 of Renmin South Road, Chengdu, 610041, Sichuan, China.
BMC Oral Health. 2024 Sep 27;24(1):1129. doi: 10.1186/s12903-024-04880-9.
Complicated crown-root fractures are a type of tooth fracture that involves the enamel, dentin, and cementum and accompanied by pulp exposure. The treatment of a complicated crown-root fracture is always challenging due to the difficulties in achieving a hermetic seal and a stable restoration with a fracture level close to the crestale bone level. This study aimed to evaluate and compare the efficacy of single-visit and multi-visit approaches for fragment reattachment in complicated crown-root fractures of anterior teeth.
Two cohort consist of 10 adolescent patients in each group at both genders, who suffered from permanent anterior tooth complicated crown-root fracture were included. Fragment reattachment with root canal treatment was performed with either single or multiple-visit approach. Single visit fragment attachement combined with root cannel therapy was conducted in single-visit approach group immediately after injury. Fragment attachment, root cananel therapy and post resoration were performed during three times ' clinical visit in multi-visit approach group.
All the patients in both groups achieved satisfactory aesthetic results one year after fragment reattachment. Patients who underwent a multi-visit approach had a significantly shorter operative duration, less intra-operative pain and fatigue, slightly better periodontal health at an early stage, and a decreased incidence of temporomandibular joint disorders compared to those who underwent a single-visit approach. However, multiple visits approach may increase the risk of fragment detachment postoperatively.
Fragment reattachment a reliable but temporary technique for adolescent patients who have suffered from complicated crown-root fractures. Multi-visit approach showed similar effecacy to single-visit approach but with slightly less complications. The choose of these two merhos should depend on the specific patient situation and patient compliance.
This prospective cohort study was retrospectively registered in Chinese Clinical Trial Registry (ChiCTR2300076811) on 19/10/2023.
复杂冠根折是一种涉及釉质、牙本质和牙骨质并伴有牙髓暴露的牙折类型。由于难以实现密封和在接近牙槽嵴骨水平的折裂处稳定修复，治疗复杂冠根折总是具有挑战性。本研究旨在评估和比较单诊和多诊在青少年前牙复杂冠根折段复位中的疗效。
纳入两组各 10 名青少年患者（男女各 10 名），均患有恒前牙复杂冠根折。采用单诊或多诊方法进行断片再附着和根管治疗。单诊组在受伤后立即采用单诊方法进行一次性断片附着联合根管治疗。多诊组在三次临床就诊期间进行断片附着、根管治疗和修复后治疗。
两组患者在断片再附着后一年均获得满意的美学效果。与单诊组相比，多诊组患者的手术时间明显缩短，术中疼痛和疲劳程度较轻，早期牙周健康状况略好，颞下颌关节紊乱的发生率降低。然而，多诊方法可能会增加术后断片脱落的风险。
断片再附着是一种可靠但暂时的技术，适用于患有复杂冠根折的青少年患者。多诊方法与单诊方法疗效相似，但并发症略少。这两种方法的选择应取决于具体的患者情况和患者的依从性。
本前瞻性队列研究于 2023 年 10 月 19 日在中国临床试验注册中心（ChiCTR2300076811）进行了回顾性注册。
