儿童恒牙脱出性损伤治疗后牙髓钙化+牙髓坏死的影响因素回顾性分析  

Retrospective analysis of influencing factors on pulp calcification and pulp necrosis after treatment of permanent tooth extraction injury in children

作　　者：廖良涛 龙旺 奉雪芳 Liao Liangtao;Long Wang;Feng Xuefang(Chenzhou Third People's Hospital,Chenzhou,Hunan 423000,China)

机构地区：[1]湖南省郴州市第三人民医院,湖南郴州423000

出　　处：《首都食品与医药》2025年第5期62-64,共3页Capital Food Medicine

摘　　要：目的 分析儿童恒牙脱出性损伤后牙髓钙化+牙髓坏死及其影响因素.方法 选择2021年1月-2023年10月在我院门诊接受治疗的恒牙脱出性损伤儿童150例为观察对象,对病历资料进行回顾性分析.分析儿童恒牙脱出性损伤部位及类型,随访1年,根据X线级临床评估结果分为预后不良组(牙髓钙化+牙髓坏死,n=30)、预后良好组(牙髓存活,n=120),收集并比较患儿临床资料及一般资料,采用多因素Logistic回归分析儿童恒牙脱出性损伤后牙髓预后不良的影响因素.结果 本研究150例恒牙脱出性损伤儿童中,随访1年后显示,牙髓坏死患儿25例(16.67%),牙髓钙化患儿5例(3.33%),牙髓存活患儿120例,存活率80.00%;外伤位置以上颌中切牙常见,占比88.00%,损伤类型以不完全脱落多见,占比41.33%.预后不良组患儿外伤类型移位、牙根发育成熟、脱出性损伤类型3级、牙周组织损伤严重、初诊叩痛阳性占比明显高于预后良好组,温度试验阳性占比明显低于预后良好组(P<0.05).多因素Logistic回归分析显示,外伤类型移位、牙根发育成熟、脱出性损伤类型3级、牙周组织损伤严重、初诊叩痛阳性均为影响儿童恒牙脱出性损伤后牙髓预后不良的危险因素(P<0.05).结论 儿童恒牙脱出性损伤以上颌中切牙、不完全脱落多见,损伤后牙髓预后不良发生率高达20%,其中外伤类型移位、牙根发育成熟、脱出性损伤类型3级、牙周组织损伤严重、初诊叩痛阳性为损伤后牙髓坏死的危险因素,对于存在高危风险患儿,应重点关注,给予针对性干预治疗有助于改善患儿预后情况.Objective To analyze the calcification and necrosis of dental pulp after permanent tooth extraction injury in children and its influencing factors.Methods A retrospective analysis of case data was conducted on 150 children with permanent tooth extraction injuries who received treatment in our outpatient department from January 2021 to October 2023.Analyze the location and type of permanent tooth extraction injury in children,follow up for 1 year,and divide them into a poor prognosis group(pulp calcification+pulp necrosis,n=30)and a good prognosis group(pulp survival,n=120)based on X-ray grade clinical evaluation results.Collect and compare clinical and general data of children,and use multiple Logistic regression analysis to identify the influencing factors of poor pulp prognosis after permanent tooth extraction injury in children.Results Among 150 children with permanent tooth extraction injury in this experiment,a one-year follow-up showed that 25 patients(16.67%)had pulp necrosis,5 patients(3.33%)had pulp calcification,and 120 patients had pulp survival,with a survival rate of 80.00%.The trauma site was common in the maxillary central incisor,accounting for 88.00%,and incomplete detachment was the most common type of injury,accounting for 41.33%.The proportion of trauma type displacement,mature root development,grade 3 prolapsed injury,severe periodontal tissue damage,and positive initial percussion pain in children with poor prognosis was significantly higher than that in the good prognosis group,and the proportion of positive temperature test was significantly lower than that in the good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that trauma type displacement,mature root development,grade 3 prolapsed injury,severe periodontal tissue injury,and positive initial percussion pain were all risk factors for poor pulp prognosis in children with permanent tooth prolapsed injury(P<0.05).Conclusion Pediatric permanent tooth extraction injury is more common in maxillary incisors and incomp

关 键 词：儿童 恒牙脱出性损伤 牙髓钙化 牙髓坏死 影响因素 

分 类 号：R788.2[医药卫生—口腔医学]