年轻上颌切牙冠折露髓的预后及影响因素回顾分析  

Retrospective study of the prognosis and influence factors of crown-fractured young maxillary incisors with pulp exposure

作　　者：王岐麟[1] 黄山娟[1] 陈洁[1] 葛立宏[1] 刘鹤[1] 

机构地区：[1]北京大学口腔医学院.口腔医院儿童口腔科,北京100081

出　　处：《华西口腔医学杂志》2011年第6期622-625,共4页West China Journal of Stomatology

摘　　要：目的回顾分析年轻恒牙冠折露髓后的预后及其影响因素。方法对1991—2008年就诊于北京大学口腔医院儿童口腔科的冠折露髓年轻恒牙的病历资料进行回顾分析,要求患者初诊治疗为活髓切断术或直接盖髓后改行活髓切断术且患者复诊时间大于2年。记录患者的年龄、初诊距外伤时间(即初诊时间)、牙根发育程度、松动度及叩痛,分析治疗效果及牙髓预后情况,并用Logistic回归分析预后的影响因素。结果共收集118例符合标准的病例,涉及患牙136颗。患儿年龄(8.8±1.2)岁,复诊时间(46.1±22.0)个月。冠折露髓后行活髓切断术的成功率为85.3%,20颗患牙发生牙髓坏死,发生时间为外伤后(25.0±19.0)个月。叩痛程度与牙髓坏死呈显著相关,患儿年龄、初诊时间及松动度是牙髓坏死的非相关因素。结论年轻恒牙冠折露髓后行活髓切断术的成功率较高。初诊时重度叩痛是牙髓坏死的重要信号,患儿年龄、初诊时间及松动度与预后之间无明显相关性。Objective The aim of the present study is to investigate the prognosis and influencing factors of crown- fractured young permanent teeth with pulp exposure. Methods Case records of crown-fractured young permanent teeth with pulp exposure in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology du- ring 1991 to 2008 with more than 2 years follow-up were collected. These patients were treated with pulpotomy at the first visit at our hospital no matter whether these teeth were treated or untreated with direct pulp capping. The age of patients, interval between trauma and treatment, root development, mobility and tenderness to percussion were recorded. The prognosis was analyzed and Logistic regression was used to analyze the influencing factors. Results To- tally 118 cases satisfied the inclusion criteria, including 136 crown-fractured teeth with pulp exposure. The patients of （8.8±1.2） years old were periodically monitored for （46.1±22.0） months. The success rate of pulpotomy after pulp exposure was 85.3%. Pulp necrosis occurred in 20 teeth （25.0±19.0） months after trauma. The extent of tenderness to percussion showed significant correlation with pulp necrosis, while the age of the patients, interval between injury and treatment, and mobility of the teeth were not related to pulp necrosis. Conclusion The success rate of pulpotomy after pulp exposure is good. Tenderness to percussion is an important signal of pulp necrosis. There are no evidence about the relationship between the patient＇s age, interval between injury and treatment, mobility of the pulp-exposed teeth and the pulp prognosis.

关 键 词：年轻恒牙 冠折露髓 活髓切断术 牙髓预后 影响因素 

分 类 号：R782.2[医药卫生—口腔医学]