牙内陷的解剖形态和治疗方案选择

Anatomical morphology and treatment options for dens invaginatus

牙内陷是一种先天性牙齿发育畸形,解剖形态差异较大,临床上可将其分为:畸形舌侧窝、畸形根面沟、畸形舌侧尖和牙中牙。大多数学者认为牙内陷是在牙齿发育期间,牙乳头的卷折所致。因其复杂的解剖形态常常引起牙周牙髓联合病变,增大治疗难度。因此,本文就Oehlers牙冠牙内陷Ⅲ型及畸形根面沟的分类、发病率、组织病理、临床表现、影像学特点、治疗方法等进行综述,以期为临床治疗提供参考和依据。文献回顾结果表明CBCT的运用有助于牙内陷的诊断、治疗及预后。根据不同的病情需要制定个性化的治疗方案,通过使用牙周牙髓联合治疗、牙髓显微外科手术、牙髓血运重建、意向性再植术等治疗技术保存患牙,提高患牙的治愈率和保存率。

Dens invaginatus is a congenital tooth developmental malformation with substantial differences in anatomical morphology. Clinically it can be divided into malformed lingual fossa, root groove deformity, lingual cusp deformity and dens in dente. Most scholars believe that dens invaginatus is caused by the folding of the nipple during tooth development. Because of the complex anatomical shape, this condition often causes periodontal pulp joint lesions, which increases the difficulty of treatment. Therefore, this paper reviews the classification, morbidity, histopathology, clinical manifestations, imaging features and treatment methods of Oehlers crown indentation type Ⅲ and malformation of the root groove to provide a reference and basis for clinical treatment. The literature review results show that the use of CBCT contributes to the diagnosis, treatment and prognosis of dens invaginatus. A personalized treatment plan should be developed based on different conditions by combining periodontal pulp therapy, pulp microsurgery, pulp revascularization, intentional replantation and other treatment techniques to preserve the teeth and improve the cure and preservation rates of teeth.