47例撕脱性损伤恒牙再植后牙根吸收的影响因素分析

Factors influencing root resorption after replantation of avulsed permanent teeth:a report of 47 teeth

目的总结撕脱性损伤恒牙的就诊特点,分析患牙再植后牙根吸收的影响因素。方法选择2017年1月至2018年12月因外伤导致恒牙撕脱性损伤前来山东大学口腔医院急诊科就诊的患者35例(47颗患牙),记录其临床信息,对脱位牙行牙再植术及松牙固定术,并进行至少1年的随访,观察患牙1年内牙根吸收的情况。结果①47颗患牙中20颗发生牙根吸收,牙根吸收的发生率为42.6%;②在1 h内完成牙再植的患牙7颗,牙根吸收的发生率为0.0%(0颗),低于1 h后再植的患牙(40颗,牙根吸收发生率为50%),差异有统计学意义(P=0.015);③根尖孔闭合的患牙牙根吸收的发生率为32.3%,低于根尖孔未闭合的患牙(62.3%),差异有统计学意义(P=0.047);④保存于唾液中的患牙(17颗)牙根吸收的发生率为17.6%,低于保存在生理盐水中(11颗,牙根吸收发生率为63.3%,P=0.020)和干燥保存(11颗,72.7%,P=0.006)的患牙,后两者无明显差异。结论患牙体外时间及保存介质是影响撕脱性损伤恒牙再植后牙根吸收的重要因素;缩短体外时间,有效保存患牙,能明显降低患牙再植后牙根吸收的发生率。

Objective To summarize the clinical characteristics of avulsed permanent teeth and to analyze the factors influencing root resorption after implantation.Methods A total of 35 patients with 47 avulsed permanent teeth due to trauma were enrolled in this study.The avulsed teeth were replanted during 2017 and 2018 in the Hospital of Stomatology,Shandong University.All cases were followed up regularly for more than 1 year.Results①Root resorption was observed in 20(42.6%)teeth during the follow-up.②For the 7 teeth replanted within 1 hour after avulsion,the rate of root resorption was 0.0%,while for the 40 teeth replanted more than 1 hour after avulsion,the rate of root resorption was 50%,and the difference was significant(P=0.015).③The rate of root resorption was significantly lower in mature cases(32.3%)than in immature cases(62.3%)(P=0.047).④Teeth stored in saliva(n=17)had a lower rate of resorption(17.6%)than teeth stored in normal saline(n=11,63.3%,P=0.020)or in dry medium(n=11,72.7%,P=0.006),and there was no difference between the latter two media.Conclusion The time elapsed from the socket and storage medium play an important role in improving the periodontal healing of avulsed teeth.Replanting the avulsed teeth in time and storing them in appropriate medium can significantly reduce the rate of root resorption.