Andreasen J O, Borum M K, Jacobsen H L, Andreasen F M
Department of Oral Medicine and Oral Surgery, University Hospital (Rigshospitalet), Denmark.
Endod Dent Traumatol. 1995 Apr;11(2):76-89. doi: 10.1111/j.1600-9657.1995.tb00464.x.
400 avulsed and replanted permanent teeth were examined for periodontal ligament (PDL) healing, using standardized radiographic and clinical examination procedures (i.e. percussion test and mobility test). The effect of various clinical factors was examined, such as age and sex of the patient, type of tooth replanted, presence of crown fracture or bone fracture, stage of root development (including apical diameter and length of the pulp), type and length of extra-alveolar storage, clinical contamination of the root surface, type of root surface cleansing procedure, type and length of splinting period and antibiotic therapy. Surface resorption was generally diagnosed after 12 months; while inflammatory resorption and replacement resorption (ankylosis) were usually observed after 1 month and 1-2 months respectively. Most resorptive processes were diagnosed within the first 2-3 years. However, although rarely, even after 5 and 10 years new resorptive processes could be diagnosed. A univariate statistical analysis of 272 teeth revealed 9 factors significantly related to PDL healing. A subsequent multivariate analysis revealed that the following 4 factors had the strongest impact upon PDL healing, in descending order of significance: Stage of root development; length of the dry extra-alveolar storage period; immediate replantation and length of the wet period (saliva or saline storage). Nonphysiological storage, such as homemade saline and sterilizing solutions (chloramine and alcohol) always led to root resorption. Storage in tap water for more than 20 minutes usually led to root resorption. The common denominator for all these factors related to PDL healing appears to be survival of the PDL cells along the root surface. Based on these findings, immediate replantation is recommended irrespective of stage of root development.
使用标准化的影像学和临床检查程序（即叩诊试验和松动度试验），对400颗脱位再植的恒牙进行了牙周膜（PDL）愈合情况检查。研究了各种临床因素的影响，如患者的年龄和性别、再植牙齿的类型、冠折或骨骨折的存在、牙根发育阶段（包括根尖直径和牙髓长度）、牙槽外保存的类型和时长、牙根表面的临床污染情况、牙根表面清洁程序的类型、夹板固定期的类型和时长以及抗生素治疗。表面吸收一般在12个月后诊断；而炎症性吸收和替代性吸收（粘连）通常分别在1个月和1 - 2个月后观察到。大多数吸收过程在最初的2 - 3年内被诊断出来。然而，尽管很少见，但即使在5年和10年后仍可诊断出新的吸收过程。对272颗牙齿进行的单因素统计分析显示，有9个因素与PDL愈合显著相关。随后的多因素分析显示，以下4个因素对PDL愈合的影响最大，按显著性降序排列为：牙根发育阶段；干燥牙槽外保存期的时长；即刻再植以及湿润期（唾液或盐水保存）的时长。非生理性保存，如自制盐水和消毒溶液（氯胺和酒精）总是导致牙根吸收。在自来水中保存超过20分钟通常会导致牙根吸收。所有这些与PDL愈合相关因素的共同特征似乎是牙根表面PDL细胞的存活。基于这些发现，无论牙根发育阶段如何，均建议即刻再植。
