Kamboozia A H, Punnia-Moorthy A
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Sydney, Australia.
Int J Oral Maxillofac Surg. 1993 Apr;22(2):97-101. doi: 10.1016/s0901-5027(05)80811-2.
The aim of this study was to compare the morbidity of permanent teeth associated with mandibular fractures treated with plates with those treated with interdental wiring. Fractures involving third molars were excluded. Sixty-three teeth in the line of fractures in 40 patients were investigated clinically (tooth vitality; periodontal status) and with periapical radiographs. Of these, 34 teeth were in the plated group and 29 teeth were in the wired group. Thirty-nine teeth adjacent to the fracture lines were also examined. The time from injury to examination ranged from 1 to 4 years. An electric pulp tester was used to measure pulpal response, corresponding teeth on the contralateral side serving as controls. Results showed that 68% of teeth in the line of fracture in the plated group were nonvital, as compared with 41% in the wired group, while 71% of teeth adjacent to the fracture line were nonvital in the plated group, as compared with 14% in the wired group. Of the total of 35 nonvital teeth in the whole group, 63% were seen in type I fracture, and 49% were related to minimal and 51% to gross displacement of fractures. These findings show a significant increase in nonvitality of teeth in the line (P = 0.018), and adjacent (P = 0.0004) to the fractures of the mandible which were treated by plates, as compared with interdental wiring. We recommend retention of teeth associated with fracture lines unless there is an absolute indication for removal.
本研究的目的是比较用钢板治疗与用牙间结扎治疗的下颌骨骨折相关恒牙的发病率。涉及第三磨牙的骨折被排除在外。对40例患者骨折线上的63颗牙齿进行了临床检查（牙齿活力；牙周状况）和根尖片检查。其中，34颗牙齿在钢板固定组，29颗牙齿在结扎组。还检查了骨折线附近的39颗牙齿。从受伤到检查的时间为1至4年。使用牙髓电活力测试仪测量牙髓反应，对侧相应牙齿作为对照。结果显示，钢板固定组骨折线上68%的牙齿无活力，而结扎组为41%；钢板固定组骨折线附近71%的牙齿无活力，而结扎组为14%。在全组35颗无活力牙齿中，63%见于I型骨折，49%与骨折的最小移位有关，51%与骨折的严重移位有关。这些结果表明，与牙间结扎相比，用钢板治疗的下颌骨骨折线上（P = 0.018）和附近（P = 0.0004）牙齿的无活力显著增加。我们建议保留与骨折线相关的牙齿，除非有绝对的拔除指征。
