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目的探讨外伤脱位牙即刻再植的临床疗效及其影响因素。方法选择1993年10月至2005年10月于江西省萍乡市人民医院和广东工业大学医院口腔科就诊的外伤脱位牙患者46例60颗牙进行即刻再植,术后随访观察5年。结果再植牙术后5年成功率为75%,累计有11例15颗再植牙失败,失败原因主要为术后牙根吸收大于根长1/3(占60%)、继发感染(占26.7%)、固定不牢靠(占13.3%)。离体时间<30 min再植牙的牙髓成活率和牙周膜愈合率均高于离体时间>30 min的再植牙,差异有统计学意义(P<0.01)。结论即刻再植外伤脱位牙经适当的临床治疗仍可保留多年,再植成功的关键是严格选择适应证、正确选择离体牙储存介质、尽快植入缩短牙离体时间、尽可能保存牙周膜活性、牢靠的固定结合功能运动和及时有效防治感染。
Objective To investigate the immediate curative effect and its influential factors of traumatic dislocation of teeth. Methods From October 1993 to October 2005, 46 cases of 60 teeth with traumatic dislocation of dental treatment in Pingxiang People’s Hospital of Jiangxi Province and Guangdong University of Technology Hospital were replanted immediately. The patients were followed up for 5 years. Results The success rate of 5 years after replantation was 75%. A total of 11 cases of replantation occurred in 11 cases. The main reasons for the failure were root resorption after operation, which was more than 1/3 (60%) of root length, secondary infection 26.7%), not firmly fixed (13.3%). The dental pulp survival rate and periodontal ligament healing rate of replantation less than 30 min in vitro were higher than that of implant replantation more than 30 min in vitro. The difference was statistically significant (P <0.01). Conclusion The immediate replantation of traumatic dislocation of the teeth can be retained for many years after proper clinical treatment. The key to success of replantation is to select indications strictly, to select the storage medium of the isolated tooth, to shorten the periodontal ligament as soon as possible and to save the periodontal Membrane activity, a solid combination of functional movement and timely and effective prevention and treatment of infections.