折裂后牙34例保存治疗的临床观察

Clinical Observation on the Conservative Treatment of 34 Cases of the Fractured Posterior Teeth

对３４例、３７颗折裂后牙不同的类型采用不同的治疗方法：表浅的隐裂牙制备哑铃形洞型作银汞合金充填；累及牙髓的隐裂牙经根管治疗后用全冠修复保护；波及牙髓的斜折牙切除斜折线以上的牙龈，经根管治疗后，以桩钉固位，光固化复合树脂或银汞合金充填配合全冠修复；纵折牙经粘结固定、根管治疗后，用全冠修复。结果：治愈１９例，明显好转１２例，失败６例，有效率为８３．８％。本文对折裂后牙的治疗方法和结果进行了讨论，认为：斜折牙的牙龈切除、灭泰混合液冲洗根管和裂隙、裂隙的严密粘结与固定，大量调整牙尖斜面、氢氧化钙碘仿糊剂充填根管、金属全冠修复保护等措施对提高折裂牙的保存率具有重要作用。

hirty four cases, including 37 fractured posterior teeth of various types have been treated by different methods.The cracked teeth without pulp involvement were filled with amalgam after having been prepared with a dumbbellshaped cavity.The cracked teeth with pulp involvement were restorated by full crown after root canal treatment.The inclined fractured teeth were restorated by lightcured composite resin and amalgam after gingivectomy of involved part,root canal treatment and fixed with pivot ,then restorated by full crown.The vertically fractured teeth were restorated by full crown after cohesion fixation and root canal treatment.The results showed:Of the 37 teeth,19(51.4%) were cured,12(32.4%) improved significantly and 6(16.2%) failed,the effective rate being 83.8%(31/37).The methods of treatment and the results were described and discussed in detail. It is suggested that resecting the involved gingiva of the inclined fractured teeth,irrigating the root canal and crack with mixture of metronidazolehibitane,cohering and fixing the crack closely,regulating the cuspal level in a large quantity,filling the root canal with paste iodoformcalcium hydroxide,restorating the cacodontia by metallic full crown etc.play an important role in raising the conservative effect of the fractured teeth.