237例儿童弯曲恒切牙的分类与疗效评价

Classification and treatment efficacy of tooth dilaceration in 237 young patients

目的:总结及分析237例儿童弯曲恒切牙的分类标准和疗效评价,为临床治疗提供依据。方法:选择在我科诊疗的6~12岁弯曲恒切牙患儿237例。通过牙科CT对弯曲牙进行三维重建,根据弯曲牙根的发育程度、弯曲部位、弯曲程度和埋藏阻生情况,将弯曲牙分为轻、中、重、严重症4个等级,与之对应的治疗方法为观察、干预、正畸复位、再植复位或拔除。结果:237例弯曲牙中,轻症12例(5%),中症22例(9%),重症168例(71%),严重症35例(15%)。接受相应的咬合诱导治疗后,95%的弯曲牙获得较满意疗效,仅11例(5%)患牙因无法保存而拔除。结论:根据我们总结的237例儿童弯曲牙的分类标准以及制定的相应治疗计划,多数弯曲牙可以有效保存,避免和减轻了患儿的牙颌畸形。

AIM To classify and evaluate the treatment effects of tooth dilaceration in 237 young patients. METHODS ： Data from 237 children ages 6-12 years treated for dilacerated permanent incisor were analyzed. Dental CT examination was conducted and 3-D images of the dilacerated teeth were reconstructed. Based on the level of root development, the location of the dilaceration, the degree of bending, and the type of embedding and impaction, the di-laceration was classified into 4 levels： mild, moderate, severe, and very severe. The corresponding treatment methods, intervention, orthodontic realignment,surgical replantation and repositioning or tooth removal were analyzed. RE-SULTS ： Based on CT scans and the assessment, 12 （5% ） , 22 （9%）, 168（71%） and 35 （15%） of the teeth were classified as mild, moderate, severe and very severe dilaceration, respectively. All patients received the appropriate occlusal induction therapy. Relatively satisfactory results were achieved in 95% of the patients, only 11 patients （5% ） had their teeth removed because the teeth could not be saved. CONCLUSION ： Most dilacerated teeth can be pre-served through comprehensive and sequential treatments following correct classification and appropriate treatment.