氢氧化钙制剂用于年轻恒牙根尖的诱导成形

Apexification of immature permanent teeth with calcium hydroxide paste

背景:氢氧化钙糊剂制剂在对根尖发育尚未完全的年轻恒牙根尖诱导成形中取得了较满意的临床效果,具有操作简便、比例均匀、导入根管后能与牙本质及根尖牙周组织充分接触等优点。目的:验证氢氧化钙制剂用于年轻恒牙实施根尖诱导成形的临床治疗效果。方法:选择因畸形中央尖折断引起的根尖周炎患者34例,其中男18例,女16例,年龄8-12岁,均实施氢氧化钙糊剂根尖诱导成形,治疗后第1,3,6,12,24个月拍摄X射线片,观察根尖封闭状况。结果与结论:34例中32例诱导成功,2例失败,诱导成功率为94%,其中16例在9-12个月出现根尖封闭,15例在12-15个月内完成根尖诱导,1例感染严重的患牙在18-21个月时完成诱导,2例在第24个月时没有完成诱导。随访2年内,无根尖周炎再次发作、牙齿松动、脱落、牙折及牙根进行性吸收等并发症,所有患牙出现Ⅱ型根尖封闭,未出现Ⅰ型和Ⅳ型,极少数介于Ⅱ型和Ⅲ之间,很难区分。证实在牙根尚未发育完全的年轻恒牙并发根尖周病变时,采用氢氧化钙制剂进行根尖诱导可起到保存患牙、减轻炎症的作用,诱导效果较好。

BACKGROUND：Preparation of calcium hydroxide paste for apexification of immature permanent teeth has recently achieved satisfactory clinical efficacy because of its advantages including simple-to-use, being wel proportioned and ful contact with dentin and root apical periodontal tissues after being guided into root canal. OBJECTIVE： To validate the clinical efficacy of apexification of immature permanent teeth with calcium hydroxide paste. METHODS：Thirty-four patients with periapical periodontitis caused by fracture of abnormal central cusp, consisting of 18 males and 16 females, aged 8-12 years, were included and they received apexification with calcium hydroxide paste. X-ray observation of the tooth apex was performed at 1, 3, 6, 12 and 24 months after operation. RESULTS AND CONCLUSION：Among the 34 cases, 32 cases were successful and 2 cases failed in apexification of immature permanent teeth with calcium hydroxide paste, the success rate was 94%. 16 cases had apical closure at 9-12 months, 15 cases finished apexification at 12-15 months, 1 case with severe infection finished induction at 18-21 months, and two cases could not finish induction at 24 months. During 2 years of folow-up period, there were no recurrence of periapical periodontitis, tooth loose and shedding, tooth fracture, root progressive absorption and other complications. Al the teeth had type II apical closure, and there were no type I and IV apical closure, and the rare cases had the type between II and III which was difficult to distinguish. Apexification with calcium hydroxide paste for immature permanent teeth with incomplete developed root can preserve the affected teeth, aleviate inflammation, and show good induction effects.