前牙完整性脱位再植根管充填临床应用

The Clinical Application of Replantion and Canal Obturation of Integrated Evulsed Anterior Teeth.

目的:评价前牙离体再植根管充填的手术疗效。方法:回顾分析1999年以来收治的96例因外伤致前牙离体脱位患者的临床资料。其中30 m in至2 h前牙离体脱位患者20例,前牙离体脱位超过2 h患者76例。结果:76例前牙离体脱位超过2 h患者离体牙经处理后,均采用复位再植,固定一次性根管充填,术后显效65例,有效5例,失败6例。30 m in至2 h以内离体牙经处理后再植复位再定,术后显效14例,其中牙髓复活4例,有效4例,失败2例。结论:因外力致完整脱位的自体牙经过处理后复位再植一次性根充治疗有明显的临床疗效。脱位牙离体时间长短关系密切、脱位牙在体外的保存方式是影响成败的主要因素。采用复位再植、固定,根管充填,防止牙骨坏死,根尖感染是目前牙离体再植较理想的术式之一。

Objectives： To evaluate the curative effect of replanting and canal obturation of integrated evulsed anterior teeth. Methods： To retrospectively analyse the clinical data of 96 patients with integrated anterior teeth evulsed because of trauma from 1999 to present ,20 cases with anterior teeth evulsed within 30min to 2h, and 76 cases with anterior teeth evulsed over 2 hours were studied. Results： The evulsed anterior teeth were replanted and fixed, with canal obturated in one time, within 76 cases evulsed over 2 hours, 65 cases were excellent, 5 cases were effective and 6 cases were ineffective or failure. Within 20 cases cruised within 30min -2h, 14 cases were excellent, 4 cases were effective and 2 cases were ineffective or failure. Conclusion ： Replantation and canal obduration have signifant curative effect in treating the evulsed an- terior teeth. The influence factors of success or failure are the time of evulsion and the method of washing and disinfecting. Replantation ,canal obturatation and fixation to prevent osteonecrosis and apical infection are better choice in treating integrated evulsed anterior teeth.