再植根管充填前牙完整性脱位临床应用.docVIP

再植根管充填前牙完整性脱位临床应用[摘要] 目的 评价前牙离体再植根管充填的手术疗效。方法 回顾分析年收治的100例因外伤致前牙离体脱位患者的临床资料。其中30min至2h前牙离体脱位患者24例，前牙离体脱位超过2h患者76例。结果 76例前牙离体脱位超过2h患者离体牙经处理后，均采用复位再植，固定一次性根管充填，术后显效65例，有效5例，失败6例。30min至2h以内离体牙经处理后再植复位再定，术后显效14例，其中牙髓复活4例，有效4例，失败2例。结论 因外力致完整脱位的自体牙经过处理后复位再植一次性根充治疗有明显的临床疗效。脱位牙离体时间长短关系密切、脱位牙在体外的保存方式是影响成败的主要原因。采用复位再植、固定，根管充填，防止牙骨坏死，根尖感染是目前牙离体再植较理想的术式之一。 [关键词] 牙齿离体； 再植根充 [中图分类号] R782.12[文献标识码] A[文章编号] 1005-0515（2011）-08-001-02 [Abstract] Objective To evaluate the curative effect of replanting and canal obturation of integrated evulsed anterior teeth.Methods To retrospectively analyse the clinical data of 100 patients with anterior teeth evulsed because of trauma.24 cases with anterior teeth were replanted and fixed with canal obturated in one time within 76 cases evulsed over 2 hours were studied.Results The evulsed anterior teeth were replanted and fixed,with canal obturated in one time,within 76 cases evulsed over 2 house, 65 cases were excellent,5 cases were effective and 6 cases were ineffective or failure. Within 20 cases evulsed within 30min-2h,14 cases were excellent,4 cases were effective and 2 cases were ineffective or failure.Conclusion Replantation and canal obturation have signifant curative effect in treating the evulsed anterior teeth.The influence factors of success or failure are the time of evulsion and the method of washing and disinfecting.Replanttation,canal obturatation and fixation to prevent osteonecrosis and apical infection are better choice in treating antegrated evulsed anterior teeth. [Key words] Evulsed teeth； Replantation and canal obturation 牙齿脱位再植术，是将因外伤致完全脱位的自体牙经过处理后复位再植固定并一次性根管治疗或复位再植固定的手术。由于外伤引起的牙齿大多发生在前牙，因此牙齿缺失后会直接影响面部的美观和语言功能。我院空腔科自1999年6月至2004年11月收治96例病人中76例采用复位再植固定一次性根管治疗临床应用，疗效结果报告如下。 1 材料与方法 1.1 临床资料 本组100例，男78例，女22例，其中11-18岁20例，19-50岁76例。脱位原因：交通事故伤54例(56.2%)，斗殴伤26例(27%)，跌落伤16例(16.6%)。牙齿为单个或3个中切牙和侧切牙缺失，牙槽骨无缺损性骨折。离体时间在30min内12个牙，30min至2h为8个牙，超过2h者为76个牙，离体最长为12h。脱位牙保存方式：清洁后置矿泉水或清水内43个牙，置生理盐水中20个牙，用纱布包裹12个牙，手握6个牙，放在口腔