埋伏阻生牙导致牙根外吸收邻牙的预后的临床观察
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摘要
目的探讨埋伏阻生牙导致邻牙(恒牙)牙根外吸收(ERR)时,阻生牙拔除术后邻牙的预后。方法以埋伏阻生牙导致邻牙(恒牙)ERR但可以正常行使功能的63例患者的75颗ERR邻牙作为研究对象,微创拔除埋伏阻生牙后,术后随访6月,观察ERR邻牙的预后情况,并分析预后与患者年龄、性别、牙根数量、牙根吸收类型、牙根吸收程度的关系。结果在75颗ERR邻牙中,67颗(89.3%)为无症状活髓牙。ERR邻牙的预后与患者的年龄相关(r=0.330,P<0.05),年龄低于30岁者ERR邻牙均保持了无症状活髓。ERR邻牙的预后与性别、牙根数量、牙根吸收类型、牙根吸收程度无相关性(P>0.05)。结论对于因相邻埋伏阻生牙导致的牙根外吸收而无临床症状的恒牙,有较大概率在阻生牙拔除术后保存活髓,建议密切随访观察,不必行预防性根管治疗。
Objective This study aimed to investigate the prognosis of permanent teeth with external root resorption(ERR caused by adjacent impacted teeth. Methods A total of 75 ERR teeth(permanent teeth) caused by adjacent impacted teeth of 63 patients were included. The prognosis of ERR teeth was analyzed followed by minimally invasive extraction of the adjacent impacted teeth. The time of follow-up was six months. The relationship between prognosis of ERR teeth and patients' age, gender, root number, type of root resorption and degree of root resorption were analyzed. Results In the 75 ERR teeth,67 teeth(89.3%) did not show pulpitis symptoms. The clinical outcome was found to be related with age(r=0.330, P<0.05),whereas no relationships with gender, root number, as well as type and degree of root resorption were observed(P>0.05).Pulpitis symptom was not found in ERR teeth of patients under 30 years old. Conclusion For ERR teeth caused by adjacent impacted teeth, keeping the pulp vital after surgical removal of impacted teeth is highly probable. Post-operative follow-up instead of preventive root canal therapy of ERR teeth is recommended.
Objective This study aimed to investigate the prognosis of permanent teeth with external root resorption(ERR caused by adjacent impacted teeth. Methods A total of 75 ERR teeth(permanent teeth) caused by adjacent impacted teeth of 63 patients were included. The prognosis of ERR teeth was analyzed followed by minimally invasive extraction of the adjacent impacted teeth. The time of follow-up was six months. The relationship between prognosis of ERR teeth and patients' age, gender, root number, type of root resorption and degree of root resorption were analyzed. Results In the 75 ERR teeth,67 teeth(89.3%) did not show pulpitis symptoms. The clinical outcome was found to be related with age(r=0.330, P<0.05),whereas no relationships with gender, root number, as well as type and degree of root resorption were observed(P>0.05).Pulpitis symptom was not found in ERR teeth of patients under 30 years old. Conclusion For ERR teeth caused by adjacent impacted teeth, keeping the pulp vital after surgical removal of impacted teeth is highly probable. Post-operative follow-up instead of preventive root canal therapy of ERR teeth is recommended.
引文
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[9]Abd-Elmeguid A, Yu DC. Dental pulp neurophysiology:part 2. Current diagnostic tests to assess pulp vitality[J]. J Can Dent Assoc, 2009, 75(2):139-143.
[10]华成舸.微创拔牙的刚体力学分析[J].华西口腔医学杂志, 2017, 35(2):119-123.Hua CG. Geostatics in minimally invasive surgical exodontias[J]. West China J Stomatol, 2017, 35(2):119-123.
[11]Holcomb JB, Dodds RN, England MC. Endodontic treatment modalities for external root resorption associated with impacted mandibular third molars[J]. J Endod, 1983, 9(8):335-337.
[12]Pai AV, Khosla M. Root resection under the surgical field employed for extraction of impacted tooth and management of external resorption[J]. J Conserv Dent, 2012, 15(3):298-302.
[2]Wang DM, He XT, Wang YL, et al. External root resorption of the second molar associated with mesially and horizontally impacted mandibular third molar:evidence from cone beam computed tomography[J]. Clin Oral Investig,2017, 21(4):1335-1342.
[3]JawadZ,CarmichaelF,HoughtonN,etal. Areviewof cone beam computed tomography for the diagnosis of root resorption associated with impacted canines, introducing an innovative root resorption scale[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2016, 122(6):765-771.
[4]Katkar RA. Mesially inclined third molars may or may not be associated with external root resorption in adjacent second molars[J]. J Evid Based Dent Pract, 2015, 15(3):131-133.
[5]Ahangari Z, Nasser M, Mahdian M, et al. Interventions for the management of external root resorption[J]. Cochrane Database Syst Rev, 2010(6):CD008003.
[6]Fuss Z, Tsesis I, Lin S. Root resorption—diagnosis, classification and treatment choices based on stimulation factors[J]. Dent Traumatol, 2003, 19(4):175-182.
[7]Consolaro A, Bittencourt G. Why not to treat the tooth canal to solve external root resorptions? Here are the principles[J]. Dent Press J Orthod, 2016, 21(6):20-25.
[8]Al-Momani Z, Nixon PJ. Internal and external root resorption:aetiology, diagnosis and treatment options[J]. Dent Update, 2013, 40(2):102-112.
[9]Abd-Elmeguid A, Yu DC. Dental pulp neurophysiology:part 2. Current diagnostic tests to assess pulp vitality[J]. J Can Dent Assoc, 2009, 75(2):139-143.
[10]华成舸.微创拔牙的刚体力学分析[J].华西口腔医学杂志, 2017, 35(2):119-123.Hua CG. Geostatics in minimally invasive surgical exodontias[J]. West China J Stomatol, 2017, 35(2):119-123.
[11]Holcomb JB, Dodds RN, England MC. Endodontic treatment modalities for external root resorption associated with impacted mandibular third molars[J]. J Endod, 1983, 9(8):335-337.
[12]Pai AV, Khosla M. Root resection under the surgical field employed for extraction of impacted tooth and management of external resorption[J]. J Conserv Dent, 2012, 15(3):298-302.