年轻恒牙牙釉质-牙本质折断牙髓预后影响因素分析

Analysis on influencing factors for pulp prognosis in young permanent teeth with enamel-dentin fracture

目的 分析年轻恒牙牙釉质-牙本质折断后1年内牙髓预后影响因素。方法 回顾性纳入2017年6月至2020年6月四川大学华西口腔医院和天津医科大学口腔医院儿童口腔科收治的牙釉质-牙本质折断的患牙资料。根据外伤后1年的牙髓预后将其分为牙髓状况正常组和异常组,收集两组患者的相关资料,采用Cox回归分析牙髓预后影响因素。结果 共纳入68例患儿85颗患牙,患儿平均年龄(8.94±1.52)岁,其中31颗(36.47%)患牙1年内出现牙髓状况异常,单因素分析结果发现,不同伤诊间隔、叩诊情况、牙龈状况、根尖暗影情况、松动度、充填情况、复诊次数的患牙,其牙髓预后差异有统计学意义(P<0.05),Cox回归分析得预后指数为PI=-0.437×复诊次数-3.685×充填-0.001×伤诊间隔,即复诊次数(HR=0.646)、是否充填(HR=0.025)和伤诊间隔(HR=0.999)是患儿外伤后1年内牙髓状况的影响因素。结论 鼓励患儿在外伤后应及时就诊、接受充填治疗、并按时复诊,对改善其1年内患牙牙髓预后有积极影响。

Objective To analyze the influencing factors for pulp prognosis within one year after enamel-dentin fracture of young permanent teeth. Methods The data of teeth with enamel-dentin fracture respectively treated in the Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University and the Department of Pediatric Dentistry, Stomatological Hospital, Tianjin Medical University from June 2017 to June 2020 were retrospectively included. According to the pulp prognosis one year after trauma, the patients were divided into the normal pulp group and the abnormal pulp group. The relevant data of the two groups were collected and Cox regression analysis was performed to analyze the influencing factors for pulp prognosis. Results A total of 85 affected teeth of 68children were included. The average age of the children was(8.94±1.52) years. Among them, 31(36.47%) teeth had abnormal pulp status within one year. The results of univariate analysis showed that there was statistically significant difference in pulp prognosis among the teeth with different trauma-diagnosis intervals, percussion results, gingival status, apical shadow, tooth mobility, filling, and number of return visits(P< 0.05). According to the Cox regression analysis, the prognostic index was PI=-0.437×the number of return visits-3.685×filling-0.001×trauma-diagnosis interval. In other words, the number of return visits(HR=0.646), filling or not(HR=0.025) and trauma-diagnosis interval(HR=0.999) were the influencing factors for pulp status within one year after trauma. Conclusion Encouraging children to visit a doctor in time after trauma, receive filling treatment, and have return visits on time will have a positive effect on improving the pulp prognosis of the affected teeth within one year.