儿童恒牙全脱出牙髓组织预后的回顾性研究

A retrospective study on pulpal tissue prognosis of avulsed permanent teeth in children

目的:观察儿童恒牙全脱出后再植牙的牙髓组织预后类型,牙髓坏死出现的时间,分析影响再植牙牙髓组织预后的因素。方法:对2000年至2012年在北京大学口腔医院就诊的儿童恒牙全脱出且观察期大于12个月的病例进行回顾性研究,观察再植牙的牙髓组织预后方式,牙髓坏死、钙变出现的时间,分析影响再植牙预后的相关因素,并进行统计学分析。结果:超过30 min再植的全脱出牙再植后60 d内全部发生了牙髓坏死,且出现牙髓坏死的时间明显早于30 min内再植的全脱出牙(P<0.05);30 min内再植的牙齿80%(4/5)牙髓存活,主要表现为牙髓钙变。结论:离体时间会影响再植牙的牙髓组织预后,超过30 min再植的牙齿牙髓几乎没有存活机会,临床上应考虑施行牙髓摘除术。

Objective： To analyze the pulpal prognosis of replanted permanent teeth in children and to examine the associated factors. Methods： The samples consisted of 67 children with 81 avulsed permanent teeth treated in Peking University Hospital of Stomatology from 2000 to 2012. Their clinical data of the replanted teeth were collected,and the follow-up period was no less than 12 months. The pulpal prognosis was classified as pulp necrosis and pulp non-necrosis. Results： The replantation within 30 minutes after avulsion led to the most significant increase in pulpal healing（ P〈 0. 05）. The dental pulp of 80%（ 4 /5） young permanent teeth replanted within 30 minutes remained vital,while all the teeth replanted after 30 minutes developed pulp necrosis within 60 days after replantation. Conclusion： The extra-alveolar period significantly affects the prognosis of pulp in immature permanent teeth after replantation. When the extra-alveolar period is more than 30 minutes,the chance of pulp revascularization after replantation is very low,therefore pulp extirpation should be performed.