牙髓血运重建治疗年轻恒牙弥漫性牙髓炎的回顾性分析  

Retrospective analysis of pulp revascularization in immature permanent teeth with diffuse pulpitis

作　　者：彭楚芳[1] 赵玉鸣[1] 杨媛[1] 刘鹤[1] 秦满[1] Peng Chufang Zhao Yuming Yang Yuan Liu He Qin Man(Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology ＆ National Engineering Laboratory for Digital and Material Technology of Stomatology ＆ Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China)

机构地区：[1]北京大学口腔医学院口腔医院儿童口腔科口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室,100081

出　　处：《中华口腔医学杂志》2017年第1期10-15,共6页Chinese Journal of Stomatology

摘　　要：目的：评价牙髓血运重建术治疗因弥漫性牙髓炎摘除牙髓的年轻恒牙的临床效果，为此类年轻恒牙的治疗提供新思路。方法回顾2009年9月至2012年9月在北京大学口腔医学院·口腔医院急诊科诊断为弥漫性牙髓炎拔髓后转至儿童口腔科行牙髓血运重建术的年轻恒牙17颗，收集治疗前后临床记录和影像学资料，评价治疗的成功率，并测量和比较治疗前后X线片上患牙和对侧同名牙牙根长度和根管壁厚度的变化。结果17颗牙的平均复查时间为（25.8±9.9）个月（12～46个月）。13颗牙无不适临床症状和体征，牙根长度和根管壁厚度增加，治疗成功；其余4颗牙根长度和根管壁厚度均有增加，根尖孔闭合，但在12～36个月出现根尖周病变，治疗失败。X线测量结果显示，患牙与对侧同名牙术后牙根长度和根管壁厚度增加量差异均无统计学意义（P〉0.05）。结论年轻恒牙牙髓炎在拔髓后行牙髓血运重建术治疗，可以获得与正常发育牙齿相似的牙根长度和根管壁厚度，但长期观察有根管再感染的可能。Objective To evaluate the treatment effectiveness of revascularization in immature permanent teeth with diffuse pulpitis and to provide an alternative approach for the treatment of these teeth. Methods Clinical and radiographic data were collected from 17 immature permanent teeth which were diagnosed as diffuse pulpitis and with their pulp extirpated at Emergency Department of Peking University School and Hospital of Stomatology. All these teeth were treated using pulp revascularization at Department of Pediatric Dentistry. Clinical success rate was then evaluated based on the clinical and radiographic findings. The increase of root length and dentin wall thickness of the revascularized teeth and the contralateral control teeth were measured and compared according to the preoperative and recall periapical radiographs. Results The average follow-uptime is （25.8±9.9） months （12-46 months）. Totally 13 out of the 17 teeth showed normal clinical and radiographic manifestation and achieved the increasein root length and dentin wall thickness. They met criteria for success treatment. The rest 4 out of the 17 teeth also showed root length and dentin wall thickness increaseand apical foramen closure. However, periapical inflammations were observed during 12 to 36 monthfollow-ups. These cases were recognized as failed. In all the17 teeth, the increase of root length and dentin wall thickness was not significantly different between the revascularized teeth and the contralateral control teeth （P〉0.05）. Conclusions Pulp revascularization in young permanent teeth with diffuse pulpitis resulted in similar clinical outcomes in root development and root canal wall formation compared with the contralateral control teeth. However, reinfection might occur during long-term follow-up.

关 键 词：牙髓炎 牙髓摘除术 牙髓血运重建术 年轻恒牙 

分 类 号：R781.31[医药卫生—口腔医学]