影响后牙折裂的相关因素分析

Analysis of factors associated with posterior fractured teeth

目的:分析238颗后牙折裂牙的临床检查情况,探讨其可能的影响因素。方法:来自212个患者的238颗诊断为后牙折裂,记录患者年龄、性别、牙位、折裂牙的隐裂线走向,是否有充填体,临床症状和体征。结果:238颗患牙确诊为牙折裂,其中诊断为牙隐裂163颗(68.5%),牙根纵裂28颗(11.8%),牙齿劈裂20颗(8.4%),牙尖折裂27颗(11.3%)。其中190颗(79.8%)患牙咬合测试疼痛。患者的年龄从25～70岁(20～29,5.4%,30～39岁,25.5%,40～49,34.1%。50～59,24.9%,60～69,10.2%。>70,0.9%),性别差异没有显著性(男性48.6%,女性51.4%,P>0.05)。上颌第一磨牙发病率最高(37.8%),下颌第一磨牙次之(21.0%),下颌第二磨牙17.2%,上颌第二磨牙12.2%。73.5%的牙折裂发生在充填过的牙齿,发生牙根纵裂的28颗牙齿中有22颗(78.6%)有根管治疗史。结论:咬合测试是最可靠的牙折诊断指标;牙折更易发生于窝洞充填过的牙齿;牙根纵裂的发生与根管治疗有关。对折裂牙根据其临床特征进行早期诊断及治疗有利于保留患牙,恢复咬合功能。

Objective To analyze the characteristics, distribution, and associated factors of longitudinal fractured teeth. Methods 238 posterior teeth from 212 patients with longitudinal fracture were analyzed. The patient＇s signs,symptoms, age,and sex were noted as well as the tooth number, with/without restoration,crack direction, pulp vitality, whether the patient had undergone endodontic treatment, bite test results,percussion test results,wear facet,and periodontal pocket depth. Results 163 （68.5%） teeth were diagnosed with a cracked tooth, 28 （11.8%）were diagnosed with vertical root fracture （VRF）,20（8.4%）had a split tooth, and 27（11.3%） had a fractured cusp; 190 （79.8%）showed a sensitive reaction on the bite test. Longitudinal tooth fractures were observed most frequently in patient in their 40s.The upper first molar （37.8%） was most frequently cracked, followed by the lower first molar （21.0%）,the lower second molar （17.2%）, and the upper second molar （12.2%）. Most longitudinal tooth fractures （73.5%） occurred mainly in restored teeth, whereas only 26.5% were found in intact teeth.Out of 28 of vertical root fracture,22 （78.6） were treated endodontically and 6 （21.4%） were not. Conclusion The bite test is most reliable for reproducing symptoms. The incidence and prevalence of longitudinal fractured teeth were commonly associated with intracoronal restorations.There was significant correlation between the prevalence of vertical root fracture and endodontic treatment.The clinical characteristics of fractured teeth is very helpful in early prevention and treatment.