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一名16岁患者复杂冠折的治疗:病例报告

Management of a Complicated Crown Fracture in a 16-Year-Old Patient: A Case Report.

作者信息

Bogovska-Gigova Ralitsa

机构信息

Department of Pediatric Dentistry, Faculty of Dental Mediciene, Medical University of Sofia, 1431 Sofia, Bulgaria.

出版信息

Reports (MDPI). 2025 Aug 1;8(3):132. doi: 10.3390/reports8030132.

DOI:10.3390/reports8030132
PMID:40843874
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12372160/
Abstract

: Traumatic dental injuries, particularly complicated crown fractures of permanent incisors, are common in adolescents, with maxillary central incisors most frequently affected due to their prominent position. These injuries, often resulting from sports or accidents, require prompt management to prevent complications such as pulp necrosis or infection, which can compromise long-term prognosis. Fragment reattachment offers a conservative, esthetically favorable approach when the fractured segment is intact, with outcomes comparable to composite restorations. This case report underscores the importance of timely intervention and advanced restorative techniques in pediatric dentistry. : A 16-year-old male presented with a complicated crown fracture of the upper left central incisor sustained during a soccer game. The fracture extended subgingivally with pulp exposure. The patient preserved the fragment in saline. Treatment involved fragment reattachment using a dentin bonding agent and flowable composite resin, followed by single-visit root canal therapy due to delayed presentation (48 h). A glass fiber post was placed to reinforce the restoration due to significant coronal loss. Three years of follow-up visits (1, 3, 6, 12, 24, and 36 months) revealed no clinical or radiographic complications, with the tooth remaining asymptomatic and functional. : This case underscores the effectiveness of fragment reattachment when combined with meticulous technique and long-term monitoring.

摘要

创伤性牙损伤,尤其是恒牙切牙的复杂冠折,在青少年中很常见,上颌中切牙因其突出位置最常受累。这些损伤通常由运动或事故引起,需要及时处理以防止牙髓坏死或感染等并发症,这些并发症会影响长期预后。当骨折段完整时,碎片重新附着提供了一种保守、美观的方法,其结果与复合树脂修复相当。本病例报告强调了儿童牙科及时干预和先进修复技术的重要性。一名16岁男性在足球比赛中左上中切牙发生复杂冠折。骨折延伸至龈下并暴露牙髓。患者将碎片保存在盐水中。治疗包括使用牙本质粘结剂和流动复合树脂进行碎片重新附着,由于就诊延迟(48小时),随后进行一次性根管治疗。由于冠部大量缺损,放置了玻璃纤维桩以加强修复。三年的随访(1、3、6、12、24和36个月)显示没有临床或影像学并发症,牙齿保持无症状且功能正常。本病例强调了碎片重新附着与精细技术和长期监测相结合的有效性。

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本文引用的文献

1
Long-Term Follow-Up of a Patient with Ankylosis of a Primary Incisor Caused by Trauma: A Case Report.一名因外伤导致乳切牙强直患者的长期随访:病例报告
Reports (MDPI). 2025 Feb 26;8(1):27. doi: 10.3390/reports8010027.
2
Fragment Reattachment: A Conservative Approach to Restoring Traumatic Fractures in Anterior Dentition.碎片重新附着:一种修复前牙列创伤性骨折的保守方法。
J Esthet Restor Dent. 2025 May;37(5):1233-1247. doi: 10.1111/jerd.13433. Epub 2025 Mar 8.
3
Management of Complex Root Fractures in Young Patients-Case Series and a Literature Review.
年轻患者复杂牙根折裂的治疗——病例系列及文献综述
J Clin Med. 2024 Nov 10;13(22):6753. doi: 10.3390/jcm13226753.
4
Long-term complications and management of dental trauma in the adult patient - Part 1: fractured teeth, pulpal complications and resorption.成人牙外伤的长期并发症及处理 - 第 1 部分:牙折、牙髓并发症和吸收。
Br Dent J. 2024 Jul;237(2):95-105. doi: 10.1038/s41415-024-7641-z. Epub 2024 Jul 26.
5
Fragment Reattachment: A 4-Year Case Report of Uncomplicated Dental Fractures.断片再附着:4 年无并发症牙折病例报告。
Int J Periodontics Restorative Dent. 2023 Nov 3;43(6):707-703. doi: 10.11607/prd.6222.
6
Pediatrician-Reported Injury Prevention Anticipatory Guidance by Patient Age Group.儿科医生报告的按患者年龄组划分的伤害预防预期指导。
Acad Pediatr. 2023 Apr;23(3):610-615. doi: 10.1016/j.acap.2023.01.008. Epub 2023 Jan 20.
7
Single versus multiple visits for endodontic treatment of permanent teeth.单次就诊与多次就诊治疗恒牙牙髓病的效果比较。
Cochrane Database Syst Rev. 2022 Dec 13;12(12):CD005296. doi: 10.1002/14651858.CD005296.pub4.
8
Prevalence and Patterns of Traumatic Dental Injuries in the Permanent Dentition: A Three-Year Retrospective Overview Study at the University Dental Clinic of Vienna.维也纳大学牙科诊所一项为期三年的回顾性研究:恒牙创伤性牙损伤的流行率和模式。
Int J Environ Res Public Health. 2022 Nov 25;19(23):15725. doi: 10.3390/ijerph192315725.
9
Complicated Crown Fracture of Permanent Incisors: A Conservative Treatment Case Report and a Narrative Review.恒牙切牙复杂冠折:一例保守治疗病例报告及文献综述
Bioengineering (Basel). 2022 Sep 18;9(9):481. doi: 10.3390/bioengineering9090481.
10
Survival analysis of fragment reattachments and direct composite restorations in permanent teeth after dental traumatic injuries.恒牙牙外伤后牙体组织碎片再附着与直接复合树脂修复的生存分析
Dent Traumatol. 2023 Feb;39(1):49-56. doi: 10.1111/edt.12789. Epub 2022 Sep 18.