牙内陷分型标准与治疗理念新进展

Progress of research on classification and treatment strategies of dens invaginatus

牙内陷是一种牙齿形态发育畸形,其复杂的解剖结构增加了临床诊断和治疗的难度.锥形束CT结合数字化软件可以重建牙内陷的三维结构,对牙内陷的诊断、治疗及预后观察有重大意义.根管显微镜、超声技术、新型生物材料等新技术的应用使尽量保存牙髓活力与保留牙齿成为可能.治疗时要考虑患者的临床症状、牙髓感染情况、内陷严重程度、根尖发育情况、根尖周组织破坏程度等,制定个性化治疗方案.该文回顾了牙内陷的病因、流行病学、分型、诊断和治疗的最新进展,重点放在分型与治疗方法上,以期为临床治疗提供参考.

Dens invaginatus is a developmental malformation in dental morphology. The complex anatomy of affected teeth can make diagnosis and endodontic management challenging. The diagnosis, treatment and prognosis of dens invaginatus has made progress with the application of three-dimensional imaging techniques such as cone beam CT combined with digital software in endodontics. Advanced treatment options such as dental operation microscope, ultrasonic technology and biomaterials bring hope for maintaining pulp vitality and teeth that could not be saved before. Treatment depends on the clinical symptoms, pulp infection, complexity of invagination, development of apical and periapical tissue destruction. The aim of this article is to review the etiology, prevalence, classification, diagnosis and management of teeth affected by dens invaginatus. Emphasis will be placed on its classification and treatment.