4~9岁儿童下颌乳磨牙根尖周病对恒牙发育影响的影像学分析  

The effects apical periodontitis of primary molar on the development of permanent teeth in children aged 4-9 years

作　　者：吴文彬 黄文燕 吕锦鸿 向茜 葛林虎[1] 曾素娟[1] WU Wenbin;HUANG Wenyan;LV Jinhong;XIANG Xi;GE Linhu;ZENG Sujuan(Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine,Guangdong Engineering Research Center of Oral Restoration and Reconstruction,Department of Pediatric Dentistry,Affiliated Stomatology Hospital of Guangzhou Medical University,China,510182)

机构地区：[1]广州市口腔再生医学基础与应用研究重点实验室,广州省口腔组织修复与重建工程技术研究中心,广州医科大学附属口腔医院儿童口腔科,510182

出　　处：《实用口腔医学杂志》2025年第1期98-103,共6页Journal of Practical Stomatology

基　　金：广东省医学科学技术研究基金项目(编号:A2021034);广州市卫生健康科技项目一般引导项目(编号:20221A010064)。

摘　　要：目的:探讨广州市儿童下颌乳磨牙根尖周病对下颌继承恒前磨牙发育状况的影响。方法:纳入335例4~9岁一侧患根尖周病,而另一侧同名牙正常健康的患儿,观察其全口曲面断层片,按牙位分为下颌第一乳磨牙(A组,n=200)及下颌第二乳磨牙(B组,n=135)(A1及B1亚组为根尖周炎组,A2及B2亚组为健康对照组),统计分析乳牙牙根破坏程度、继承恒牙牙囊破坏及发育程度、近远中方向改变及萌出高度。结果:7岁组的A1组及6岁组的B1组继承恒牙发育程度分别低于同龄的A2组及B2组(P<0.05)。6~7岁组的A1组中男生继承恒牙发育程度较女生迟缓(P<0.05)。A1组及B1组中继承恒牙牙囊破坏及方向改变在性别上均无差异(P>0.05)。随着乳牙破坏程度加深,A1组的继承恒牙方向改变占比增加(P<0.05),而B1组的继承恒牙方向改变占比无差异(P>0.05)。乳牙受炎症破坏程度与继承恒牙牙囊破坏程度间呈正相关性(rA1=0.41,rB1=0.21,P<0.05)。7~8岁组的A1组继承恒牙萌出高度高于A2组(P<0.05),各年龄组的B1组与B2组间继承恒牙萌出高度均无明显差异(P>0.05)。结论:在乳牙牙根稳定期后期,乳牙根尖周炎症可能造成继承恒牙发育延迟,且男生延迟程度高于女生,随着乳牙根尖周组织破坏程度加深,可能造成其继承恒牙牙囊破坏加深,并且下颌第一前磨牙较易出现早萌现象。Objective:To investigate the effects of apical periodontitis of mandibular primary molars on the development of mandibular permanent premolars in children in Guangzhou.Methods:335 children aged 4-9 years with apical periodontitis of mandibular primolar at one side and normal healthy homologous tooth at another side were included and divided into 2 groups:Group A(n=200)included the first mandibular premolars and group B(n=135)included the second mandibular premolars.Subgroup A1 and B1 were the apical periodontitis groups,subgroup A2 and B2 were the normal healthy groups.The degree of root destruction of primary teeth,the degree of destruction and development of the dental follicle of permanent teeth,the mesial and distal direction changes,and the eruption height were observed and measured on the panoramic raidiographs,data were statistically analyzed.Results:In the 7-year-old children of A1 and the 6-year-old of B1 groups,the development degree of successor permanent teeth was lower than that of group A2 and group B2 of the same age children respectively(P<0.05).In the 6-7-year-old children of group A1,the permanent teeth development of boys was slower than that of the girls(P<0.05).There was no gender difference in dental follicle destruction and malposition of the permanent teeth in both A1 and B1 groups(P>0.05).The proportion of malposition of the successor permanent teeth in group A1 increased with the primary teeth damage degree increace(P<0.05),while the proportion of malposition of the successor permanent teeth in group B1 showed no significant difference(P>0.05).Positive correlation between the damage degree of primary teeth and dental follicle of permanent teeth was observed(rA1=0.41,rB1=0.21,P<0.05).In boys aged 7-8 years,the succesor permanent teeth eruption in group A1 was higher than that in group A2(P<0.05),and there was no significant difference between group B1 and group B2(P>0.05).Conclusion:In the later stages of root stabilization of primary molars,periapical inflammation of primary teeth may ca

关 键 词：恒牙 根尖周炎 牙囊 下颌乳磨牙 曲面断层片 

分 类 号：R788[医药卫生—口腔医学] R816.98[医药卫生—临床医学]