Borum M K, Andreasen J O
Department of Pediatric Dentistry, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark.
Endod Dent Traumatol. 1998 Feb;14(1):31-44. doi: 10.1111/j.1600-9657.1998.tb00806.x.
Two hundred and eighty-seven children with a total of 545 traumatized primary upper incisors were followed using standardized procedures until the age of 10. Extraction was the only treatment offered when intervention was necessary. The immediate as well as the long-term consequences of trauma were studied on the basis of this material. Consequences in the primary dentition comprised: color changes (53%), pulp necrosis (25%), pulp canal obliteration (36%), gingival retraction (6%), permanent displacement after luxation (5-22%), pathological root resorption (1-10%) as well as disturbances in physiological root resorption (4%) and, lastly, premature tooth loss (46%). In a multivariate analysis of the development of pulp necross in primary teeth after trauma, the following decisive factors were found: age of the patient at the time of injury, degree of displacement of the tooth as well as the degree of loosening and presence of crown fracture. The factors found to influence development of pulp canal obliteration were: displacement of the tooth at time of injury as well as detectable physiologic root resorption at time of trauma. The presence of crown fracture seemed to decrease the risk of obliteration. The need for scientifically based treatment strategies for managing and reducting complications after trauma in the primary dentition is stressed.
对287名儿童共545颗受创伤的上颌乳切牙采用标准化程序进行随访，直至10岁。必要时，拔牙是唯一的治疗方法。基于这些资料研究了创伤的即刻和长期后果。乳牙列的后果包括：颜色改变（53%）、牙髓坏死（25%）、根管闭锁（36%）、牙龈退缩（6%）、脱位后恒牙移位（5%-22%）、病理性牙根吸收（1%-10%）以及生理性牙根吸收障碍（4%），最后还有过早失牙（46%）。在对乳牙创伤后牙髓坏死发展的多因素分析中，发现了以下决定性因素：受伤时患者的年龄、牙齿移位程度以及松动程度和冠折情况。发现影响根管闭锁发展的因素有：受伤时牙齿的移位以及创伤时可检测到的生理性牙根吸收。冠折的存在似乎降低了根管闭锁的风险。强调了需要有科学依据的治疗策略来处理和减少乳牙创伤后的并发症。
