畸形中央尖折断所致年轻恒前磨牙根尖周炎再生性牙髓治疗效果观察

Effect of regenerative endodontic treatment on young premolar with periapical periodontitis caused by fractured abnormal central cusp

目的观察对畸形中央尖折断所致的年轻恒牙根尖周炎进行再生性牙髓治疗的临床疗效。方法选择2014年3月至2015年9月大连市口腔医院儿童口腔科因畸形中央尖折断引起的年轻恒前磨牙急、慢性根尖周炎的10～13岁患儿10例，共11颗前磨牙，经彻底控制炎症后行再生性牙髓治疗。定期随访观察，结合影像学检查，与术前进行对比，评价根尖周病变的愈合状况及牙根发育情况。结果1颗患牙因引血入根管失败而放弃再生性牙髓治疗，改行根尖诱导成形术。其余10颗均实施再生性牙髓治疗，术后观察10～23个月，根尖周炎症状均消失，牙根变长，根管壁增厚，根尖聚拢，获得较好疗效。2例出现髓腔部分钙化现象。结论对年轻恒牙根尖周炎进行再生性牙髓治疗较传统的根尖诱导成形术具有不可比拟的优势。

Objective To observe the clinical curative effect of regenerative endodontic treatment on young premolar with periapical periodontitis which is caused by broken abnormal central cusp. Methods Totally 11 young premolars with periapical periodontitis caused by fractured abnormal central cusp, consisting of 10 cases, aged 10-13 years, were collected in Department of Pediatric Dentistry of Dalian Stomatological Hospital from March 2014 to September 2015. After thorough control of inflammation, regenerative endodontic treatment was performed. X-ray observation of the periapical inflammation healing and root development was performed after operation. Results One patient dropped out from the study because of failure of puncture bleeding （diverted to apexification）, while the other 10 all received regenerative endodontic treatment, and regular postoperative observation lasted 10-23 months. All symptoms of periapical inflamma- tion disappeared; root thickening and lengthening were observed in 10 cases. There are 2 cases of part calcification in medullary cacity. Conclusion In the treatment of young permanent teeth with periapical periodontitis, regenerative end- odontic treatment has incomparable advantages compared with the traditional apexification.