根尖诱导成形术治疗感染型畸形中央尖的临床观察  

Effect of apexification on prognosis of infected abnormal central cusp teeth

作　　者：杨婕[1] 朱玲[1] 马华思[1] 

机构地区：[1]南京医科大学口腔医学研究所南京医科大学附属口腔医院儿童牙科,江苏南京210029

出　　处：《临床口腔医学杂志》2009年第1期45-47,共3页Journal of Clinical Stomatology

基　　金：南京医科大学校自然科学基金面上项目(编号2006034)

摘　　要：目的:研究感染型畸形中央尖患牙根尖诱导后的临床疗效,并观察不同根尖孔形状对牙根闭合的影响。方法:选择59个已发生牙髓感染的畸形中央尖患牙,采取根尖诱导促进牙根发育、根尖闭合。结果:经2年追踪观察,术后患牙100%临床症状消失,93.22%完成根尖封闭。14个根尖内聚型患牙术后根尖发育完成,平均闭合时间6.64个月;19个根尖平行型,8个根尖发育完成,另11个根管腔无缩窄,但根尖达到闭合,平均闭合时间10.58个月;26个根尖喇叭口型3个根尖闭合,19个在根尖孔处形成钙化桥,4个形成根管内不规则钙化桥,平均闭合时间16.91个月。随着治疗进展,患牙根尖孔直径逐步缩窄,术前根尖孔直径平均1.99mm,术后平均0.88mm,但仍高于健康对照牙(p=0.03,<0.05)。结论:感染型畸形中央尖经根尖诱导治疗可获得良好预后。不同根尖孔形态的畸形中央尖其临床疗效无明显差别。术前根尖内聚型或平行型患牙,术后根尖发育接近生理性闭合状态,术前根尖孔呈喇叭口型者可影响牙根发育成正常根尖形态。Objective： To study the effect of apexification on curative efficacy and apical closure of infected abnormal central cusp teeth. Method：59 infected abnormal central cusp teeth collected from 26 cases were treated with apexification. Result： After two years follow-up observation, the success rate in terms of clinical symptoms was 100%, while in terms of apical closure the success rate was 93.22%. 14 teeth with convergent apex obtained physiological apical shapes and average time taken to obtain apical closure was 6.64 months. Among 19 teeth with parallel apical walls, 8 teeth obtained physiologi- cal apical shapes, 11 teeth obtained apical closure but didn＇t obtain narrow root canal and average time was 10.58 months. Among 26 teeth with divergent apex, 3 teeth obtained apical closure, 19 teeth ended with calcification bridge in apex and 4 teeth with irregular calcification bridge post-treatment and average time was 16.91 months. During treatment the apical di- ameter of teeth with apicoformation progressively decreased in size from 1.99 mm to 0.88 mm, yet it was larger than healthy contralateral teeth （p--0.03, 〈 0.05）. Conclusion： Infected abnormal central cusp teeth could obtain favourable prognosis with apexification. Clinical efficacy of different apical foramen shape teeth had no statistical significance. Teeth with convergent or parallel apical shapes were apt to result in physiological apical shapes post-treatment： divergent apex of the teeth before treatment hindered apical closure.

关 键 词：感染型畸形中央尖 根尖闭合 根尖孔形状 

分 类 号：R781.05[医药卫生—口腔医学]