乳牙根尖周炎致恒牙胚坏死病例报告及文献复习  

Permanent successor necrosis caused by periapical periodontitis of deciduous teeth:a case report and litera-ture review

作　　者：卢洁 王迎菊[2] 张利娟 李帆 李姗姗 谭凯璇[1,2] 张颖 杨芳[2] LU Jie;WANG Yingju;ZHANG Lijuan;LI Fan;LI Shanshan;TAN Kaixuan;ZHANG Ying;YANG Fang(College of Stomatology,Dalian Medical University,Dalian 116044,China;Center of Stomatology,Qingdao Municipal Hospital Affiliated to Qingdao University,Qingdao 266011,China)

机构地区：[1]大连医科大学口腔医学院,辽宁大连116044 [2]青岛大学附属青岛市市立医院口腔医学中心,山东青岛266011

出　　处：《口腔疾病防治》2020年第9期590-593,共4页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金面上科学基金项目(81670979)。

摘　　要：目的探讨乳牙严重根尖周炎致牙槽骨吸收引起继承恒牙胚坏死的病因、诊断及治疗原则,为临床诊疗提供参考。方法对一例罕见的恒牙胚坏死病例的临床资料及相关文献进行回顾性分析。结果本例患者为5岁女孩,查体及X线片检查发现75慢性根尖周炎。X线片显示牙周骨质广泛性破坏,35牙胚周围硬骨板包绕不完整,较45发育滞后。初期诊断35牙胚因炎症停止发育,后期拔除75时发现35牙胚已坏死,术后病理检查报告为:35牙胚多处死骨形成。文献复习结果显示,根尖周病变程度及牙胚的发育阶段对继承恒牙胚有较大影响,治疗上多采取根管治疗等保守方法。乳牙根尖周炎致恒牙胚坏死在临床很罕见,应根据临床症状与影像学表现及早判断炎症浸润程度及恒牙胚受损程度,正确作出相应治疗计划。结论临床对于恒牙胚病理状态的诊断还未形成客观明确的诊断和治疗标准,因此对于发育异常的恒牙胚通常采取消除病因,随访观察等手段。今后的研究方向应致力于预防及寻找更有效的诊断及治疗方法。Objective To investigate the etiology,diagnosis and treatment principles of inherited permanent tooth embryo necrosis caused by alveolar bone resorption due to severe periapical periodontitis of deciduous teeth,in order to provide a reference for clinical diagnosis and treatment.Methods The clinical data and related literature of a rare case of permanent tooth embryo necrosis were analyzed retrospectively.Results This case was a 5-year-old girl.Physical examination and X-ray examination revealed chronic periapical inflammation in 75.X-ray showed that the periodon-tal bone of tooth 75 was extensively destroyed;additionally,the permanent tooth germ of tooth 35 was incomplete and the development was delayed compared to that of tooth 45 because of severe periapical periodontitis in the primary teeth.The initial diagnosis was that--the embryo of tooth 35 stopped developing due to inflammation and was necrotic after tooth 75 was extracted.The postoperative pathological examination report showed that most bone around the embry-os of tooth 35 was sequestrated.Through literature review and analysis,it was found that the degree of periapical lesions in the primary teeth and the developmental stage of the tooth embryo have a great impact on the formation of permanent tooth embryos.Conservative methods such as root canal therapy are usually adopted as treatment.Permanent tooth embryo necrosis caused by periapical periodontitis of deciduous teeth is rare in the clinic,so it is necessary to judge the degree of inflammatory infiltration and of tooth embryo damage as soon as possible according to the clinical symptoms and imaging manifestations;and to make a correct treatment plan.Conclusion There are no objective and clear diagnostic and treatment criteria for the clinical diagnosis of the pathological state of permanent tooth embryo,thus,methods such as etiology elimination and follow-up observation are usually adopted for abnormal permanent tooth embryo development.Future research should focus on prevention and finding addtio

关 键 词：继承恒牙胚 坏死 乳牙 根尖周炎 牙槽骨吸收 病因 诊断 治疗 

分 类 号：R78[医药卫生—口腔医学]