Oulis C J, Berdouses E D
Department of Paediatric Dentistry, University of Athens Dental School, Greece.
Endod Dent Traumatol. 1996 Apr;12(2):60-5. doi: 10.1111/j.1600-9657.1996.tb00098.x.
Although there are several epidemiological studies on dental trauma internationally, there are not many studies that record, analyse and follow different kinds of dental trauma treated in a private office, and that evaluate how parameters such as type of dental trauma, as well as time lapse until treatment might influence the final outcome and the prognosis of the teeth. The sample consisted of 242 patients, 6-17 years of age, with 369 injured teeth treated within a period of 5 years. All the case were treated by the first author and were followed for at least 3 years. The treatment modalities used were based upon the clinical examination and the history of the case and included direct and indirect pulp capping, partial pulpotomy, pulpotomy, pulpectomy and splinting. The type of trauma was classified based on WHO classification partially modified. Seventy six percent of the teeth suffered only hard tissue injuries and 22% had only periodontal ligament PDL) trauma. Of the total number of teeth class I represented 3%, class II 59%, class III 20% and class IV 2%. Of the PDL injuries 14% of the teeth suffered concussion, 69% luxation and 17% exarticulation. The highest incidence of dental trauma was observed at the age of 10. Sixty eight percent of the patients sought treatment 3 days or more after the trauma had occurred delayed treatment), while only 32% within the first 3 days (immediate treatment). The main reasons for delayed treatment were neglect (50%) and unawareness 37%). Of the teeth with delayed treatment 43% became necrotic, while only 28% of the teeth that were treated on time needed pulpectomy. Luxations caused more pulp necrosis (46%) than Class I (0%) Class II (7%) or Class III (34%) type of trauma. The data from this study suggested that a most of the dental injuries on permanent teeth were class II or III type, b) a high percentage (68%) of the patients sought treatment more than 3 days after the injury (delayed treatment), c) delayed treatment caused more necrotic teeth, d) the public should be informed of the importance of immediate treatment in an effort to improve the prognosis of the pulp, e) dentists should be informed of the appropriate treatment of dental injuries since 10.3% of the cases were mistreated.
尽管国际上有多项关于牙外伤的流行病学研究，但记录、分析和跟踪私人诊所治疗的不同类型牙外伤，并评估牙外伤类型以及治疗前的时间间隔等参数如何影响牙齿最终结局和预后的研究并不多。样本包括242名6至17岁的患者，在5年期间内治疗了369颗受伤牙齿。所有病例均由第一作者治疗，并至少随访3年。所采用的治疗方式基于临床检查和病例史，包括直接和间接盖髓术、部分牙髓切断术、牙髓切断术、牙髓摘除术和牙弓夹板固定。牙外伤类型根据部分修改后的世界卫生组织分类进行划分。76%的牙齿仅遭受硬组织损伤，22%仅发生牙周膜（PDL）损伤。在牙齿总数中，I类占3%，II类占59%，III类占20%，IV类占2%。在PDL损伤中，14%的牙齿遭受震荡，69%脱位，17%牙脱位。牙外伤的最高发病率出现在10岁。68%的患者在牙外伤发生3天或更长时间后才寻求治疗（延迟治疗），而只有32%在头3天内（立即治疗）。延迟治疗的主要原因是疏忽（50%）和意识不足（37%）。在延迟治疗的牙齿中，43%发生坏死，而及时治疗的牙齿中只有28%需要进行牙髓摘除术。脱位导致的牙髓坏死（46%）比I类（0%）、II类（7%）或III类（34%）牙外伤类型更多。这项研究的数据表明，a）恒牙的大多数牙损伤为II类或III类类型，b）高比例（68%）的患者在受伤3天以上后才寻求治疗（延迟治疗），c）延迟治疗导致更多坏死牙齿，d）应告知公众立即治疗的重要性，以努力改善牙髓预后，e）由于10.3%的病例治疗不当，应告知牙医牙外伤的适当治疗方法。
