影响延迟植入和保存不佳全脱位恒牙再植成功率因素初探
发布时间：2018-10-05 20:25
【摘要】：研究背景 离体时间长短，和体外保存方式被认为是主要影响全脱位牙再植成功率的两大因素。而目前临床上求诊的全脱位患牙，大多离体时间较长，且不能被保存于理想介质中。本研究着重于此类患牙，试图找出影响此类患牙再植成功率的因素。主要对暂时性根管充填药物和牙根发育阶段这两大因素初探研究。 实验一Vitapex糊剂应用于全脱位牙再植后牙髓干预疗效评价 目的：评价Vitapex糊剂作为全脱位牙复位固定后暂时性充填材料，患牙再植后疗效。方法：选取牙根发育成熟，全脱位前牙，36颗，离体时间1-2h，干燥保存。局麻下复位，树脂牙弓夹板固定。1w后，常规开髓、摘髓、根管预备、消毒。2w后，随机分为A、B两组。A组使用水调氢氧化钙充填，B组使用Vitapex充填。3m，，6m，12m复诊检查。12m后若牙根稳定改牙胶尖加AH Plus糊剂永久充填。使用spss13.0软件对实验数据进行x2检验。结果：A组成功率为88.9%，B组为83.3%，两组间无统计学差异。 实验二年轻恒牙再植后疗效评价 目的：研究牙髓保留对根尖未闭合的全脱位恒牙再植预后的影响。方法：选取因外伤全脱位的年轻恒牙，离体时间介于1-2h之间，干燥保存，共13颗。局麻下复位，使用树脂牙弓夹板固定，调合避免早接触。另选取根尖已经闭合全脱位恒牙作为对照组，其余标准与实验组相同，共13颗。对照组首次处理同实验组，复位固定1w后开髓、摘髓、扩根、冲洗后Vitapex糊剂充填。3m、6m、12m、18m复诊常规检查并拍摄牙片，观察评价患牙再植疗效。对照组复诊时若发现糊剂吸收不密合即更换糊剂。随访观察18m后，根据是否发生牙根炎症性吸收评价治疗效果。采用spss13.0软件包对数据进行χ2检验。结果：再植18m后，实验组成功率为46.2%，对照组成功率为84.6%，两组间具有统计学意义。 结论： 1.氢氧化钙和氢氧化钙复合制剂Vitapex，在离体时间长，保存条件不佳的全脱位牙复位后牙髓治疗中，作为暂时性根管充填材料，对于预防牙根吸收的疗效确切。Vitapex操作方便、安全。对于全脱位恒牙牙髓治疗中值得推广使用。 2.根尖未闭合的全脱位恒牙，如果离体时间超过1h，且未保存于理想介质中，或者患牙污染严重，保守治疗，再植成功率显著低于平均水平。应该考虑新的治疗方法和手段，提高其再植成功率。
[Abstract]:Background the length of time in vitro and the way of preservation in vitro are considered to be the two main factors affecting the success rate of total dislocation replantation. However, most of the total dislocated teeth which have been treated clinically are not preserved in the ideal medium and can not be preserved in the ideal medium. This study focuses on this kind of teeth and tries to find out the factors that influence the success rate of replantation. A preliminary study was made on the two major factors of temporary root canal filling and dental root development. Objective: to evaluate the effect of Vitapex paste on pulp intervention after total dislocation tooth replantation objective: to evaluate the effect of Vitapex paste as temporary filling material after total dislocation reduction and fixation. Methods: 36 teeth with fully dislocated anterior teeth were selected for 1-2 h dry preservation. After reduction under local anesthesia and fixation with resin arch splint for 1 week, pulp opening, pulpion extraction, root canal preparation, disinfection for 2 weeks were performed. Group A was randomly divided into two groups. Group A was filled with water calcium hydroxide. Group B was treated with Vitapex filling. Use spss13.0 software to test the experimental data. Results the success rate was 83.3 in group B and 88.9 in group A, and there was no significant difference between the two groups. Objective: to study the effect of pulp retention on the prognosis of permanent teeth with unclosed apical replantation. Methods: 13 young permanent teeth with traumatic total dislocation were selected and preserved for 1-2 hours. Reduction under local anesthesia, fixed with resin arch splint, blending to avoid early contact. In addition, 13 permanent teeth with closed total dislocation of root tip were selected as control group. The control group was treated for the first time. After 1 week of reduction and fixation, the pulp was opened, the pulp was removed, and the root was reexpanded. After washing, Vitapex paste was filled with 0.3mO6mO12mand 18m, then the routine examination was made and the dental film was taken to evaluate the curative effect of replantation of the affected teeth. In the control group, if it was found that the paste was not absorbed closely, the paste was replaced. After 18 m follow-up, the therapeutic effect was evaluated according to whether the root inflammatory absorption occurred. The data were tested by 蠂 2 test with spss13.0 software package. Results: after replantation for 18 m, the success rate was 46.2 in the experimental group and 84.6 in the control group. Conclusion: 1. Vitapex, a compound preparation of calcium hydroxide and calcium hydroxide, was used as a temporary root canal filling material in the treatment of total dislocation teeth with long time in vitro and poor preservation conditions. As a temporary root canal filling material, it is effective and safe to prevent root resorption. It is worth popularizing in the treatment of permanent pulp for total dislocation. 2. If the total permanent teeth with unclosed apical teeth were not preserved in the ideal medium for more than 1 hour, or the teeth were seriously polluted, the success rate of conservative treatment and replantation was significantly lower than the average level. New treatment methods and methods should be considered to improve the success rate of replantation.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.6
本文编号：2254763
[Abstract]:Background the length of time in vitro and the way of preservation in vitro are considered to be the two main factors affecting the success rate of total dislocation replantation. However, most of the total dislocated teeth which have been treated clinically are not preserved in the ideal medium and can not be preserved in the ideal medium. This study focuses on this kind of teeth and tries to find out the factors that influence the success rate of replantation. A preliminary study was made on the two major factors of temporary root canal filling and dental root development. Objective: to evaluate the effect of Vitapex paste on pulp intervention after total dislocation tooth replantation objective: to evaluate the effect of Vitapex paste as temporary filling material after total dislocation reduction and fixation. Methods: 36 teeth with fully dislocated anterior teeth were selected for 1-2 h dry preservation. After reduction under local anesthesia and fixation with resin arch splint for 1 week, pulp opening, pulpion extraction, root canal preparation, disinfection for 2 weeks were performed. Group A was randomly divided into two groups. Group A was filled with water calcium hydroxide. Group B was treated with Vitapex filling. Use spss13.0 software to test the experimental data. Results the success rate was 83.3 in group B and 88.9 in group A, and there was no significant difference between the two groups. Objective: to study the effect of pulp retention on the prognosis of permanent teeth with unclosed apical replantation. Methods: 13 young permanent teeth with traumatic total dislocation were selected and preserved for 1-2 hours. Reduction under local anesthesia, fixed with resin arch splint, blending to avoid early contact. In addition, 13 permanent teeth with closed total dislocation of root tip were selected as control group. The control group was treated for the first time. After 1 week of reduction and fixation, the pulp was opened, the pulp was removed, and the root was reexpanded. After washing, Vitapex paste was filled with 0.3mO6mO12mand 18m, then the routine examination was made and the dental film was taken to evaluate the curative effect of replantation of the affected teeth. In the control group, if it was found that the paste was not absorbed closely, the paste was replaced. After 18 m follow-up, the therapeutic effect was evaluated according to whether the root inflammatory absorption occurred. The data were tested by 蠂 2 test with spss13.0 software package. Results: after replantation for 18 m, the success rate was 46.2 in the experimental group and 84.6 in the control group. Conclusion: 1. Vitapex, a compound preparation of calcium hydroxide and calcium hydroxide, was used as a temporary root canal filling material in the treatment of total dislocation teeth with long time in vitro and poor preservation conditions. As a temporary root canal filling material, it is effective and safe to prevent root resorption. It is worth popularizing in the treatment of permanent pulp for total dislocation. 2. If the total permanent teeth with unclosed apical teeth were not preserved in the ideal medium for more than 1 hour, or the teeth were seriously polluted, the success rate of conservative treatment and replantation was significantly lower than the average level. New treatment methods and methods should be considered to improve the success rate of replantation.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.6
【参考文献】
相关期刊论文 前2条
1 周卓君;朱亚琴;;12例牙根未发育成熟全脱位恒牙再植后疗效评价[J];口腔材料器械杂志;2013年01期
2 陈发明,孙海花,贾保军,王娜,邓玲玲,刘民;引导性组织再生术对脱位再植年轻恒牙牙周愈合和牙髓牙根变化的影响[J];牙体牙髓牙周病学杂志;2003年08期
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