年轻恒前牙2类和3类牙折改良间接和直接盖髓术初探

Improved indirect and direct pulp capping therapy in type Ⅱ and type Ⅲ tooth fractures of young permanent anterior teeth

目的:进行无症状年轻恒前牙Ellis 2类牙折和3类牙折保髓治疗新方法的初步探讨。方法:采用改良间接和直接盖髓术--即刻Vitapex间接或直接护髓和树脂冠修复的方法,对35颗外伤冠折的年轻恒前牙进行完整牙髓的保存治疗,并定期复查。结果:35颗外伤上前牙,在最长两年的观察期内,有3例出现慢性牙髓炎的临床表现,失败率为8.6%,其中Ellis 2类牙折2例,3类牙折1例,3例失败病例的根端形态均为根管壁内聚状。有4例出现树脂冠松动或脱落,占11.4%,其中Ellis 2类牙折1例,3类牙折3例。结论:根端形态是判断年轻恒牙外伤后牙髓有无恢复可能的主要因素。采用Vitapex护髓、制作简单并且对儿童牙颌发育影响小的树脂冠来增加固位,技术要求低,为冠折年轻恒前牙保留完整牙髓提供了一种新方法。

Objective：To study the possibility of improved indirect and direct pulp capping therapy for the whole pulp preservation in type II and type III（Ellis＇s classification） tooth fractures of young permanent anterior teeth.Method：35 young anterior permanent teeth were involved in this investigation.15 teeth were type II tooth fracture and 20 teeth were type III tooth fracture.All the teeth were protected indirectly or directly by Vitapex and immediately protected by the resin crown.Result：The success rate of Vitapex placement and resin crown protection after two years is 91.6 %.The stages of root development of these 3 failure cases are all developed types.Only 4 cases had resin crown loosened,of which 1 is type II tooth fracture and 3 is type III tooth fracture.Conclusion：This new and technology-simple treatment may give a possible and successful choice to preserve the whole pulp for type II and type III tooth fractures of young permanent anterior teeth,especially for the tooth at the early stage of root development.