儿童外伤全脱位牙的应急处理与再植后的替代性吸收

The emergency handling of the avulsed teeth in children and the replacement resorption after tooth replantation

目的:分析儿童外伤全脱位牙的应急处理与牙再植后替代性吸收间的关系,并比较校内、外儿童外伤全脱位牙应急处理的差异。方法:19例牙外伤全脱位病人,共计21个全脱位患牙纳入本实验。记录外伤发生地点,并记录患牙应急处理的情况,如保存状态(是否进行即刻再植)、保存的方法、外伤就诊时间等,通过2年的定期随访,观察再植牙发生替代性吸收的情况。用四格表的确切概率法进行检验,显著性水平设定为P<0.05。结果:失访全脱位牙3个,未进行统计。在统计的18个患牙中,校外发生11个,校内发生7个。校内发生者湿保存42.86%(3/7),高于校外发生的27.27%(3/11),二者有显著性差异(P<0.05);发生于校内者有42.86%(3/7)2h内就诊,高于校外发生的18.18%(2/11),二者也有显著性差异(P<0.05)。2h内就诊的患牙产生替代性吸收的比例均显著低于2～24h及24h后就诊的患牙(P<0.05)。湿保存的再植牙替代性吸收的比例比干燥保存的低,二者均有显著性差异(P<0.05)。结论:学校老师相对比家长对全脱位牙的相关处理信息了解得更多,但二者均处于较低的水平,而患牙的保存和是否及时就诊均会影响再植牙替代性吸收的发生。

AIM： To analyze the relationship between the emergency handling of the avulsed teeth in children and the replacement resorption after replantation, and compare the manner in which the avulsed teeth were handled at school versus outside school. METHODS： The material included 21 avulsed permanent teeth of 19 children. The following informarion was recorded： the place where the dental traumas were suffered, the emergency handling of the avulsed teeth（such as storage condition, storage means） and the time elapsed after trauma. The teeth were followed up for 2 years regularly to observe the replacement resorption. The analysis of the data was performed using exact propability of fourfold table with a critical value of 0. 05. RESULTS ： For all 21 avulsed teeth in the study, 3 teeth were failed to be followed, and they were ruled out from the data. Of 18 teeth,ll teeth experienced avulsion outside school and the other 7 suffered traumas at school Of 7 teeth avulsed at school, 42.85% （3/7） were kept under wet conditions, and also 42.85% （3/7）were visited within 2 hours. Of 11 teeth avulsed outside school, 27.27% （3/11） were kept under wet conditions, and 18.18% （2/11） were visited within 2 hours. Each ratio of the teeth avulsed outside school was lower than that at school, and the difference was significant（P 〈 0. 05）. The ratio of replacement resorption after replantation for the avulsed teeth visited within 2 hours was lower significantly than that for the teeth visited 2 to 24 hours after trauma（P 〈0.05）, it＇s also lower than the ratio for the teeth visited 24 hours later（P 〈0.05）. And the ratio of replacement resorption after replantation for the avulsed teeth kept under wet conditions was lower than that for the teeth kept under dry conditions （ P 〈 0.05 ）. CONCLUSION ： School teachers relatively knows more information about the avulsed tooth than the parents. However, both of them are in low level. How the avulsed teeth were stored and if the teeth were visited promptly would play some roles in the occurrence of the replacement resorption after replantation.