Chinese Journal of Practical Stomatology ›› 2021, Vol. 14 ›› Issue (5): 569-574.DOI: 10.19538/j.kq.2021.05.012

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  • Online:2021-09-30 Published:2021-09-30

牙髓血运重建术治疗年轻恒牙牙髓坏死伴根尖周病变临床疗效及锥形束CT影像定量评价

李佳洋,周梦琪,韦晓玲   

  1. 上海市口腔医院牙体牙髓病科,上海市颅颌面发育与疾病重点实验室,上海  200001
  • 基金资助:
    上海市卫生健康委员会面上项目(201740051)

Abstract: Objective    To evaluate the clinical effect of pulp revascularization for  immature permanent teeth with pulp necrosis and periapical lesions  and carry out a quantitative assessment based on cone-beam CT (CBCT). Methods    From January to November of 2018,18 immature permanent teeth(mandibular premolars with single canal)with pulp necrosis and periapical lesions were treated in the Department of Endodontics,Shanghai Stomatology Hospital for pulp revascularization,and they were included in the study. The follow-up period was 18 months,during which clinical and imaging data were collected,clinical efficacy was analyzed,and the changes in radiographic root area,apical foramen diameter and root length were quantitatively evaluated by CBCT,and the factors that might affect postoperative root development were analyzed. Results    The clinical symptoms all disappeared after treatment in the 18 teeth;the effective rate was 100%. The treatment was successful in 15 cases (83.3%) and 3 cases got better (16.7%). Compared with those before treatment,the radiographic root area increased by an average of 83.78%,the diameter of the apical foramen decreased by 50.78%,and the root length increased by an average of 24.61%. Age (>17 years old) was related to whether the root continued to grow,while gender and apical hole size were not related. Conclusion    For young permanent teeth with pulp necrosis and periapical lesions,pulp revascularization can promote development of the root. Age(>17 years old)is a factor that affects the level of root development after treatment.

Key words: pulp revascularization, immature permanent teeth, pulp necrosis, periapical lesions

摘要: 目的 探讨运用牙髓血运重建术治疗年轻恒牙牙髓坏死伴根尖周病变的临床疗效并进行影像学定量评价。方法    选择2018年1—11月于上海市口腔医院牙体牙髓病科就诊的18例年轻恒牙牙髓坏死伴根尖周病变患者的18颗患牙(均为单根管的下颌前磨牙),行牙髓血运重建术。术后随访18个月,期间收集临床及影像学数据,分析临床疗效并对牙根影像面积、根尖孔直径以及牙根长度变化进行CBCT影像定量评估,分析可能影响术后牙根发育的因素。结果 所有18颗经过治疗的患牙临床症状均消失,无叩痛、松动及窦道,有效率为100%,其中成功15例(83.3%)、好转3例(16.7%)。以术前为基准,术后18个月牙根影像面积平均增加83.78%,根尖孔直径平均减少50.78%,牙根长度平均增加24.61%;年龄(是否大于17岁)与牙根是否继续发育相关,性别及根尖孔大小与牙根是否继续发育无明显相关性。结论    对于牙髓坏死伴根尖周病变的年轻恒牙,采用牙髓血运重建术可使牙根得到持续发育,年龄可影响术后牙根发育水平。

关键词: 牙髓血运重建术, 年轻恒牙, 牙髓坏死, 根尖周病变