牙外伤后根管闭锁研究进展

Pulp canal obliteration following dental trauma

根管闭锁(pulp canal obliteration,PCO)是牙外伤后常见的并发症之一,通常发生于青少年,多见于年轻恒牙。PCO的发生机制尚不明确,可能是外伤后受损的牙髓出现血管再生和(或)神经再生的结果,也可能是由于外伤本身或者复位固定外伤牙后牙髓血液流量的改变导致。对于牙外伤后出现PCO的患牙,一些学者认为根管治疗不仅可以避免出现根尖周炎症,而且有利于患牙的美容修复。大多数学者则认为可对患牙进行长期的随访观察,只有伴有PCO的外伤牙出现牙髓坏死或者发展为根尖周炎时才考虑根管治疗,而且根管治疗对PCO的患牙是一项挑战,在技术上是复杂的。总之,为了及时检测到PCO的发生,对外伤牙定期随访和密切观察是十分必要的。

Pulp canal obliteration（PCO）is one of the common complications after dental trauma,usually occurring in adolescents,more commonly in immature teeth. The exact mechanism of PCO is not fully understood,which may be an outcome of revascularization and/or reinnervation of the impaired pulp after trauma. And it also may be attributable to the trauma itself or to the changes in pulpal blood flow after repositioning and splinting of the traumatized teeth. As to the teeth with PCO following dental trauma,some scholars believe that root canal therapy is necessary to avoid apical periodontitis or for esthetic restoration. However,most scholars consider that long-term follow-up is still strongly recommended. Root canal therapy of the involved tooth should be performed only if the pulp tissue becomes necrotic or if apical periodontitis develops. Moreover,root canal therapy is a challenge for the teeth with PCO,which is technically complicated. In a word,periodic follow-up and close observation of traumatized teeth are necessary to timely detect the occurrence of PCO.dental traumapulp canal obliterationroot canal therapy