学龄儿童154颗恒前牙外伤诊治分析

Analysis of the causes and emergency management of 154 traumatized permanent incisors in primary school children

目的:调查学龄儿童恒前牙外伤的相关因素,评价对脱位牙进行即刻再植治疗的效果。方法:对122例7～12岁学龄儿童恒前牙外伤病例进行调查,了解前牙外伤的相关因素,并对外伤导致的56颗脱落牙进行即刻再植治疗,随访观察1a,评价疗效。结果:跌伤为主要外伤原因,上中切牙受伤最多,左右侧无差异。单个牙外伤在所有年龄组占多数,深覆盖的儿童遭受外伤的几率较大。154颗外伤牙中,冠折89颗,占57.79%;根折9颗,占5.84%;脱位56颗,占36.36%。大多数老师及家长不了解脱位牙保存介质问题。56颗行脱位再植牙,53颗成功,成功率为94.64%。结论:学龄儿童在学校受伤较多,在日常教育中应强调儿童的自我保护意识。外伤导致脱落的年轻恒牙再植成功率高,临床效果良好。

PURPOSE:This study was designed to investigate the related factors of permanent incisors trauma among primary school children, and evaluate the results of replantation of 56 avulsed teeth. METHODS: Data were collected by 122 questionnaire from teachers or parents of the primary school children with dental trauma, with regard to the related trauma causes, altitudes and emergency management of dental avulsion. 56 avulsed teeth were replanted immediately after appropriate manipulation. The results of replantation were evaluated 1 year later. RESULTS: Tumble (fall off) was the main cause for dental trauma. The maxillary central incisor was most vulnerable to injury, without differences between the right and the left side. Single tooth injury was predominant in all age groups. Children with an incisal overjet tended to have a greater chance of dental trauma. Crown fractures represented 89 (57.79%)of 154 traumatized teeth; root fractures represented 9 (5.84%); avulsed represented 56 (36.3%). Most teachers and parents had little knowledge of the correct procedures for replanting or transporting avulsed teeth. 53 of 56 replanted teeth (94.64%) were integrated successfully. CONCLUSION: The parents and school educators should be advised about prevention of injuries and actions to be taken in case of an accident. The functional and esthetical outcome of replantation in avulsed teeth is excellent.