年轻恒牙完全脱位再植术61例临床疗效分析(1)
[摘要] 目的 分析外伤后完全脱位的年轻恒牙再植术的临床疗效及影响因素。 方法 选取2015～2018年我科治疗的61例73颗年轻恒牙外伤脱位患者为研究对象，回顾性分析其再植术后的临床疗效。 结果 73颗完全脱位牙再植术后，经过1～3年临床观察，治疗效果：优57颗，良6颗，差10颗，再植成功率为86.3%，总体治疗效果较理想。其中伤后15 min～1 h和1 h～24 h进行再植的治疗效果明显好于伤后24 h以上再植的患牙;伤后15 min～1 h再植的治疗效果最佳。 结论 再植术是治疗年轻恒牙外伤全脱位的有效方法，再植术成功的关键是尽量保持离体牙牙周膜的活性、正确保存脱位牙并及时再植。脱位后15 min～1 h的再植效果最佳。
[关键词] 年轻恒牙;完全脱位;再植术
[中图分类号] R783 [文献标识码] B [文章编号] 1673-9701(2020)24-0074-03
[Abstract] Objective To analyze the clinical efficacy and influencing factors of replantation of young permanent teeth after complete traumatic dislocation. Methods Clinical observation and retrospective analysis were performed on 61 cases of 73 young permanent teeth with traumatic dislocation received by our department from 2015 to 2018 after replantation. Results After replantation of 73 completely dislocated teeth， clinical observation was conducted for 1 to 3 years， and the therapeutic effects were as follows： 57 excellent teeth， 6 good teeth and 10 poor teeth， the success rate of replantation was 86.3%， and the overall therapeutic effect was ideal. Among which， the therapeutic effect of replantation from 15 min to 1 h and 1 h to 24 h after injury was significantly better than the replantation over 24 h after injury; the therapeutic effect of replantation from 15 min to 1 h after injury was the best. Conclusion Replantation is an effective method for treating the complete traumatic dislocation of young permanent teeth; the key to the success of replantation is to keep the activity of the periodontal membrane in vitro as far as possible， preserve the dislocated teeth correctly and replant them in time. The best replantation effect is 15 min to 1 h after dislocation.
[Key words] Young permanent teeth; Complete dislocation; Replantation
臨床治疗中常见年轻恒牙因外伤而导致完全脱位，尤以上颌中切牙最好发，由于其解剖结构的特点，导致外伤时容易受损发生脱落[1]。外伤性前牙完全脱位常发生于儿童和青少年，是最复杂、受损最严重的一种牙齿损伤[2]。前牙脱落严重影响青少年患者的发音、面部美观、咀嚼功能、生长发育和身心发育[3]，其应急治疗需要引起临床工作者的重视。外伤脱位牙的首选治疗方法是牙齿再植术，但如果伤后应急处理不当，会影响其远期再植疗效[4]。本研究2015～2018年我科治疗的61例73颗年轻恒牙外伤脱位患者为研究对象，回顾性分析其再植术后的临床疗效及影响因素，现报道如下。
1 资料与方法
1.1 一般资料
2015～2018年我科治疗的61例73颗年轻恒牙外伤脱位患者为研究对象，其中男47例，女14例;年龄7～10岁;73颗离体牙均为年轻恒牙，根尖口均未闭锁;受伤部位：上颌中切牙60颗，上颌侧切牙13颗;受伤原因：意外摔伤、撞击伤、交通事故等;脱位时间15 min～30 h，其中15 min～1 h 51颗(44例)，1 h～24 h 14颗(11例)，24 h以上8颗(6例)。
1.2 方法
1.2.1 离体牙处理 用手或上前牙钳夹住牙冠，用冲洗器使无菌生理盐水反复冲洗牙根表面的污染物，如果污染物附着在根面上不易冲净，可用小棉球沾生理盐水小心轻柔地蘸去污物，注意避免损伤牙周膜[12]，并注意保护根面残留的牙周膜纤维[5]，将清洗干净的牙齿置于Hanks平衡盐溶液或生理盐水中待用。, 百拇医药(张昕 陆海涛)
[关键词] 年轻恒牙;完全脱位;再植术
[中图分类号] R783 [文献标识码] B [文章编号] 1673-9701(2020)24-0074-03
[Abstract] Objective To analyze the clinical efficacy and influencing factors of replantation of young permanent teeth after complete traumatic dislocation. Methods Clinical observation and retrospective analysis were performed on 61 cases of 73 young permanent teeth with traumatic dislocation received by our department from 2015 to 2018 after replantation. Results After replantation of 73 completely dislocated teeth， clinical observation was conducted for 1 to 3 years， and the therapeutic effects were as follows： 57 excellent teeth， 6 good teeth and 10 poor teeth， the success rate of replantation was 86.3%， and the overall therapeutic effect was ideal. Among which， the therapeutic effect of replantation from 15 min to 1 h and 1 h to 24 h after injury was significantly better than the replantation over 24 h after injury; the therapeutic effect of replantation from 15 min to 1 h after injury was the best. Conclusion Replantation is an effective method for treating the complete traumatic dislocation of young permanent teeth; the key to the success of replantation is to keep the activity of the periodontal membrane in vitro as far as possible， preserve the dislocated teeth correctly and replant them in time. The best replantation effect is 15 min to 1 h after dislocation.
[Key words] Young permanent teeth; Complete dislocation; Replantation
臨床治疗中常见年轻恒牙因外伤而导致完全脱位，尤以上颌中切牙最好发，由于其解剖结构的特点，导致外伤时容易受损发生脱落[1]。外伤性前牙完全脱位常发生于儿童和青少年，是最复杂、受损最严重的一种牙齿损伤[2]。前牙脱落严重影响青少年患者的发音、面部美观、咀嚼功能、生长发育和身心发育[3]，其应急治疗需要引起临床工作者的重视。外伤脱位牙的首选治疗方法是牙齿再植术，但如果伤后应急处理不当，会影响其远期再植疗效[4]。本研究2015～2018年我科治疗的61例73颗年轻恒牙外伤脱位患者为研究对象，回顾性分析其再植术后的临床疗效及影响因素，现报道如下。
1 资料与方法
1.1 一般资料
2015～2018年我科治疗的61例73颗年轻恒牙外伤脱位患者为研究对象，其中男47例，女14例;年龄7～10岁;73颗离体牙均为年轻恒牙，根尖口均未闭锁;受伤部位：上颌中切牙60颗，上颌侧切牙13颗;受伤原因：意外摔伤、撞击伤、交通事故等;脱位时间15 min～30 h，其中15 min～1 h 51颗(44例)，1 h～24 h 14颗(11例)，24 h以上8颗(6例)。
1.2 方法
1.2.1 离体牙处理 用手或上前牙钳夹住牙冠，用冲洗器使无菌生理盐水反复冲洗牙根表面的污染物，如果污染物附着在根面上不易冲净，可用小棉球沾生理盐水小心轻柔地蘸去污物，注意避免损伤牙周膜[12]，并注意保护根面残留的牙周膜纤维[5]，将清洗干净的牙齿置于Hanks平衡盐溶液或生理盐水中待用。, 百拇医药(张昕 陆海涛)