Ebeleseder K A, Friehs S, Ruda C, Hulla H, Glockner K, Pertl C
Abteilung für Zahnerhaltungskunde, Universitätsklinik für Zahn-, Mund- und Kieferheilkunde, Graz.
Mund Kiefer Gesichtschir. 1997 Nov;1(6):340-5. doi: 10.1007/BF03043580.
The aim of this investigation was a critical assessment of the short- and medium-term results of replantation of immature, avulsed permanent teeth. Thirty-nine teeth were investigated after 2.5 years on average. Only 7 teeth (18%) had been replanted within 5 min after avulsion. Sixteen teeth (41%) showed revascularisation or ingrowth of alveolar bone into the pulp. Twenty-two teeth (56%) showed signs of ankylosis, 6 (15%) had been exfoliated or extracted. Seventeen teeth (77% of the ankylotic ones) exhibited an alveolar growth arrest of 1.5 mm per 10 cm body growth. By planimetric assessment, the yearly loss of root dentin by replacement resorption was about 15%. The appearance was compromised in 11 cases (33%) by severe discoloration. In spite of intense therapeutic effort and partial success, the results must be classified as unsatisfactory. In avulsions of immature permanent teeth, replantation therefore has to be considered an intermediate solution. Since the main reason for a failure is extended extra-oral unphysiologic storage, replantation by lay helpers immediately after the accident should be propagated as a first-aid treatment to improve the situation of the replanted tooth. In addition, more attention should be paid to preserving teeth in tissue cultures before replantation.
本研究的目的是对未成熟恒牙脱位再植的短期和中期结果进行批判性评估。平均2.5年后对39颗牙齿进行了调查。只有7颗牙齿(18%)在脱位后5分钟内进行了再植。16颗牙齿(41%)显示牙髓血管再生或牙槽骨长入牙髓。22颗牙齿(56%)显示出牙根粘连的迹象,6颗(15%)已脱落或拔除。17颗牙齿(占牙根粘连牙齿的77%)每10厘米身体生长牙槽生长停滞1.5毫米。通过平面测量评估,置换性吸收导致的牙根牙本质每年损失约15%。11例(33%)因严重变色而影响外观。尽管进行了积极的治疗并取得了部分成功,但结果仍不尽人意。因此,在未成熟恒牙脱位的情况下,再植只能被视为一种折衷的解决办法。由于失败的主要原因是长时间的口外非生理性保存,应推广事故发生后由非专业人员立即进行再植作为急救治疗,以改善再植牙齿的状况。此外,在再植前应更加重视将牙齿保存在组织培养中。