儿童全脱出牙外伤的序列治疗  

Sequential treatment for tooth avulsion in children

作　　者：盛恺 汪俊[1] SHENG Kai;WANG Jun(Department of Pediatric Dentistry,Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院儿童口腔科,国家口腔疾病临床研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海200011

出　　处：《中国实用口腔科杂志》2022年第4期390-394,共5页Chinese Journal of Practical Stomatology

基　　金：上海高水平地方高校创新团队项目(SHSMUZLCX20212402);上海交通大学医学院附属第九人民医院学科特色疾病生物样本库项目(YBKB201903)

摘　　要：牙全脱出是儿童时期非常严重的牙外伤之一,通常应对其进行序列治疗,包括应急处理、诊间治疗及长期随访。在外伤发生地,将脱出的牙齿即刻再植或正确地保存患牙并及时就诊能够取得较好的预后。因此,相应的科普宣传和指导至关重要。诊间的治疗计划需要考虑牙周、牙髓的处理和辅助性治疗。牙周治疗计划的制定应根据患牙是否已再植、再植操作是否正确、是否有咬合创伤及牙槽骨是否骨折等,采取相应的处理。而牙髓治疗需根据牙根发育程度、离体时间、保存介质等决定治疗方案。对于根尖未闭合的恒牙,需要慎重权衡牙根吸收的风险与牙髓血运重建的可能性。此外,长期的随访、及时处理并发症也是重要的环节。文章就以上内容做一详细阐述,以期为临床诊疗提供参考。Tooth avulsion,one of the most severe dental traumas in childhood,usually requires sequential treatment covering emergency management,clinical treatment and longterm follow-up.Immediate replantation or correct storage of an avulsed tooth at the accident site will lead to a favorable prognosis.Thus,popularizing first aid instructions to the public is crucial.The clinical treatment plan should include periodontal,endodontic and adjuvant therapy.The periodontal treatment should be planned according to whether the avulsed tooth has been replanted,whether the replantation is correct,whether occlusal trauma exists and whether the alveolar bone is fractured.The endodontic treatment plan is decided based on the root development stage,extra-oral dry time and storage medium.For teeth with open apices,the risk of infection-related root resorption should be carefully weighed against the chances of pulp revascularization.Long-term follow-up and timely management of complications are also essential.So,the present article intends to describe the things mentioned above to provide references for clinical diagnosis and treatment.

关 键 词：全脱出 再植 序列治疗 

分 类 号：R782.1[医药卫生—口腔医学]