纵折牙口外粘接再植后行全冠修复的远期临床效果分析

Analysis of long-term clinical effects of replantation and full crown restoration on vertical fractured teeth after bonding treatment

目的回顾性分析和跟踪随访纵折牙的临床资料,评价纵折牙口外粘接后再植的临床效果。方法收集89颗纵折牙,其中牙髓治疗后的患牙占75例(占84.23%),口外完善根管治疗后,采用Super Bond C&B粘接剂粘接后,植回牙槽窝,再植术后2个月全冠修复,通过12个月、18个月、24个月及36个月患牙的牙龈指数(GI)、牙周情况、松动度、X线摄片等方面进行监测,评估临床效果。对每期的成功率进行统计学分析。结果随访12个月、18个月、24个月和36个月的成功率分别为80.90%、65.17%、51.69%和35.96%。36个月时仅有32颗患牙能恢复良好的咀嚼功能,无明显松动度,无叩痛,根尖和根分叉处骨质正常,无牙周袋。结论纵折牙口外粘接再植后3年疗效不佳,患牙的牙折裂时间、患者年龄、全身状况、牙位、咬合力及口腔卫生状况可能会影响其成功率。

Objective To analyze the clinic effects of replantation on vertical fractured teeth after bonding treatment through the retrospective analysis and the follow-up study. Methods 89 vertical fractured teeth were collected in this study, and the teeth with dental pulp treatment accounted for 75 cases（84.23%）. The teeth were extracted and treated by root canal treatment, and then bonded with Super Bond C＆B, subsequently replanted into teeth socket immediately, finally restored by full crowns after 2 months. The Gingival Index（GI）,periodontal condition, tooth mobility, and X-ray were recorded. All the information were analyzed to evaluate the clinical effect and prognosis at 12 months, 18 months, 24 months and 36 months. The success rate for each period was statistically analyzed. Results Follow-up of 12 months, 18 months, 24 months and 36 months, the success rates were respectively 80.90%, 65.17%, 51.69%, 35.96%. At 36 months after treatment, only 32 teeth exhibited good chewing function, less tooth mobility, no sensitive to percussion, normal bone structure around root apex and furcation, and no periodontal pockets. Conclusion The clinical effects of replantation treatment after 3 years were not very good. Time, age, occlusal force, physical and oral health can influence the prognosis.