Deng Minting, Wang Nan, Xia Bin, Zhao Yuming, Zhu Junxia
Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China.
Department of Dentistry, Peking University Third Hospital, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2025 Feb 18;57(1):148-153. doi: 10.19723/j.issn.1671-167X.2025.01.022.
To analyze the factors related to spontaneous re-eruption after intruded injury in permanent anterior teeth in children and adolescents.
Clinical data from 5- to 17-year-old patients who sustained intrusive luxation of permanent anterior teeth and treated in the Department of Pedia-tric Dentistry of Peking University School and Hospital of Stomatology from June 2015 to August 2024 were reviewed. Information of age, gender, degree of intrusion, direction of intrusion, tooth development, concomitant injuries, luxation and post-osteoclastic eruption of the adjacent teeth were recorded. The patients were divided into two groups based on whether they showed spontaneous re-eruption during advised observation after intrusion. Univariate and multifactor analysis were performed using Logistic regression.
Data from 170 teeth in 139 patients whose age ranging from 5.3-16.3 years [mean age (9.0± 2.1) years] were examined. A gender disparity was observed among the patients, with 84 being male and 55 being female. Among the 170 teeth, 112 were categorized as successfully spontaneous re-eruption during advised observation after intrusion, while 58 were not. In terms of the degree of intrusion, 45 teeth (26.47%) had intrusion less than 3 mm, 102 teeth (60.00%) experienced intrusion between 3-7 mm, and 23 teeth (13.53%) were faced with intrusion exceeding 7 mm. As for the direction of intrusion, 117 teeth (68.82%) were straight intrusion while mesial-distal and buccal-lingual intrusion respectively accounting for 17 (10.00%) and 23 (13.53%). Multivariate Logistic regression analysis showed that mesial-distal intrusion (=0.167, 95%: 0.031-0.9048, =0.038), intrusion of >7 mm (=0.065, 95%: 0.014-0.299, < 0.001) and luxation of adjacent teeth (=0.369, 95%: 0.144-0.944, =0.037) were independent risk factors for spontaneous re-eruption of traumatically intruded permanent anterior teeth in children and adolescents during advised observation after intrusion, while intrusion of < 3 mm (=9.860, 95%: 2.430-40.009, =0.001) and post-osteoclastic eruption of adjacent teeth (=4.712, 95%: 1.528-14.531, =0.007) were independent protective factors. The possibility of spontaneous re-eruption in permanent anterior teeth during advised observation after intrusion was decreased by 61.1% with the increase of root development using Cvek' s classification (=0.611, 95%: 0.408-0.914, =0.017). Age (=1.077, 95%: 0.763-1.521, =0.673) and laceration of gingival (=0.865, 95%: 0.290-2.578, =0.794) didn't significantly affect the spontaneous re-eruption during advised observation after intrusion.
In this study, mesial-distal intrusion, intrusion of >7 mm and luxation of adjacent teeth were independent risk factors for spontaneous re-eruption of traumatically intruded permanent anterior teeth in children and adolescents during advised observation, while intrusion of < 3 mm and post-osteoclastic eruption of adjacent teeth were served as independent protective factors.
分析儿童及青少年恒牙嵌入性损伤后自发再萌出的相关因素。
回顾2015年6月至2024年8月在北京大学口腔医院儿童口腔科就诊的5至17岁恒牙遭受嵌入性脱位的患者的临床资料。记录年龄、性别、嵌入程度、嵌入方向、牙齿发育情况、合并损伤、相邻牙齿的松动及破骨后萌出情况。根据嵌入后建议观察期间是否出现自发再萌出将患者分为两组。采用Logistic回归进行单因素和多因素分析。
检查了139例患者的170颗牙齿，年龄范围为5.3 - 16.3岁[平均年龄(9.0±2.1)岁]。患者中存在性别差异，男性84例，女性55例。在这170颗牙齿中，112颗在嵌入后建议观察期间成功自发再萌出，而58颗未再萌出。就嵌入程度而言，45颗牙齿(26.47%)嵌入小于3 mm，102颗牙齿(60.00%)嵌入3 - 7 mm，23颗牙齿(13.53%)嵌入超过7 mm。至于嵌入方向，117颗牙齿(68.82%)为垂直嵌入，近远中向和颊舌向嵌入分别占17颗(10.00%)和23颗(13.53%)。多因素Logistic回归分析显示，近远中向嵌入(β =0.167，95%CI: 0.031 - 0.9048，P =0.038)、嵌入超过7 mm(β =0.065，95%CI: 0.014 - 0.299，P <0.001)和相邻牙齿松动(β =0.369，95%CI: 0.144 - 0.944，P =0.037)是儿童及青少年创伤性嵌入恒牙在嵌入后建议观察期间自发再萌出的独立危险因素，而嵌入小于3 mm(β =9.860，95%CI: 2.430 - 40.009，P =0.001)和相邻牙齿破骨后萌出(β =4.712，95%CI: 1.528 - 14.531，P =0.007)是独立保护因素。随着使用Cvek分类法牙根发育程度增加，嵌入后建议观察期间恒牙自发再萌出的可能性降低61.1%(β =0.611，95%CI: 0.408 - 0.914，P =0.017)。年龄(β =1.077，95%CI: 0.763 - 1.521，P =0.673)和牙龈撕裂伤(β =0.865，95%CI: 0.290 - 2.578，P =0.794)对嵌入后建议观察期间的自发再萌出无显著影响。
本研究中，近远中向嵌入、嵌入超过7 mm和相邻牙齿松动是儿童及青少年创伤性嵌入恒牙在建议观察期间自发再萌出的独立危险因素，而嵌入小于3 mm和相邻牙齿破骨后萌出是独立保护因素。
