【摘要】：研究背景 離體時(shí)間長(zhǎng)短，和體外保存方式被認(rèn)為是主要影響全脫位牙再植成功率的兩大因素。而目前臨床上求診的全脫位患牙，大多離體時(shí)間較長(zhǎng)，且不能被保存于理想介質(zhì)中。本研究著重于此類患牙，試圖找出影響此類患牙再植成功率的因素。主要對(duì)暫時(shí)性根管充填藥物和牙根發(fā)育階段這兩大因素初探研究。 實(shí)驗(yàn)一Vitapex糊劑應(yīng)用于全脫位牙再植后牙髓干預(yù)療效評(píng)價(jià) 目的：評(píng)價(jià)Vitapex糊劑作為全脫位牙復(fù)位固定后暫時(shí)性充填材料，患牙再植后療效。方法：選取牙根發(fā)育成熟，全脫位前牙，36顆，離體時(shí)間1-2h，干燥保存。局麻下復(fù)位，樹脂牙弓夾板固定。1w后，常規(guī)開髓、摘髓、根管預(yù)備、消毒。2w后，隨機(jī)分為A、B兩組。A組使用水調(diào)氫氧化鈣充填，B組使用Vitapex充填。3m，，6m，12m復(fù)診檢查。12m后若牙根穩(wěn)定改牙膠尖加AH Plus糊劑永久充填。使用spss13.0軟件對(duì)實(shí)驗(yàn)數(shù)據(jù)進(jìn)行x2檢驗(yàn)。結(jié)果：A組成功率為88.9%，B組為83.3%，兩組間無統(tǒng)計(jì)學(xué)差異。 實(shí)驗(yàn)二年輕恒牙再植后療效評(píng)價(jià) 目的：研究牙髓保留對(duì)根尖未閉合的全脫位恒牙再植預(yù)后的影響。方法：選取因外傷全脫位的年輕恒牙，離體時(shí)間介于1-2h之間，干燥保存，共13顆。局麻下復(fù)位，使用樹脂牙弓夾板固定，調(diào)合避免早接觸。另選取根尖已經(jīng)閉合全脫位恒牙作為對(duì)照組，其余標(biāo)準(zhǔn)與實(shí)驗(yàn)組相同，共13顆。對(duì)照組首次處理同實(shí)驗(yàn)組，復(fù)位固定1w后開髓、摘髓、擴(kuò)根、沖洗后Vitapex糊劑充填。3m、6m、12m、18m復(fù)診常規(guī)檢查并拍攝牙片，觀察評(píng)價(jià)患牙再植療效。對(duì)照組復(fù)診時(shí)若發(fā)現(xiàn)糊劑吸收不密合即更換糊劑。隨訪觀察18m后，根據(jù)是否發(fā)生牙根炎癥性吸收評(píng)價(jià)治療效果。采用spss13.0軟件包對(duì)數(shù)據(jù)進(jìn)行χ2檢驗(yàn)。結(jié)果：再植18m后，實(shí)驗(yàn)組成功率為46.2%，對(duì)照組成功率為84.6%，兩組間具有統(tǒng)計(jì)學(xué)意義。 結(jié)論： 1.氫氧化鈣和氫氧化鈣復(fù)合制劑Vitapex，在離體時(shí)間長(zhǎng)，保存條件不佳的全脫位牙復(fù)位后牙髓治療中，作為暫時(shí)性根管充填材料，對(duì)于預(yù)防牙根吸收的療效確切。Vitapex操作方便、安全。對(duì)于全脫位恒牙牙髓治療中值得推廣使用。 2.根尖未閉合的全脫位恒牙，如果離體時(shí)間超過1h，且未保存于理想介質(zhì)中，或者患牙污染嚴(yán)重，保守治療，再植成功率顯著低于平均水平。應(yīng)該考慮新的治療方法和手段，提高其再植成功率。
[Abstract]:Background the length of time in vitro and the way of preservation in vitro are considered to be the two main factors affecting the success rate of total dislocation replantation. However, most of the total dislocated teeth which have been treated clinically are not preserved in the ideal medium and can not be preserved in the ideal medium. This study focuses on this kind of teeth and tries to find out the factors that influence the success rate of replantation. A preliminary study was made on the two major factors of temporary root canal filling and dental root development. Objective: to evaluate the effect of Vitapex paste on pulp intervention after total dislocation tooth replantation objective: to evaluate the effect of Vitapex paste as temporary filling material after total dislocation reduction and fixation. Methods: 36 teeth with fully dislocated anterior teeth were selected for 1-2 h dry preservation. After reduction under local anesthesia and fixation with resin arch splint for 1 week, pulp opening, pulpion extraction, root canal preparation, disinfection for 2 weeks were performed. Group A was randomly divided into two groups. Group A was filled with water calcium hydroxide. Group B was treated with Vitapex filling. Use spss13.0 software to test the experimental data. Results the success rate was 83.3 in group B and 88.9 in group A, and there was no significant difference between the two groups. Objective: to study the effect of pulp retention on the prognosis of permanent teeth with unclosed apical replantation. Methods: 13 young permanent teeth with traumatic total dislocation were selected and preserved for 1-2 hours. Reduction under local anesthesia, fixed with resin arch splint, blending to avoid early contact. In addition, 13 permanent teeth with closed total dislocation of root tip were selected as control group. The control group was treated for the first time. After 1 week of reduction and fixation, the pulp was opened, the pulp was removed, and the root was reexpanded. After washing, Vitapex paste was filled with 0.3mO6mO12mand 18m, then the routine examination was made and the dental film was taken to evaluate the curative effect of replantation of the affected teeth. In the control group, if it was found that the paste was not absorbed closely, the paste was replaced. After 18 m follow-up, the therapeutic effect was evaluated according to whether the root inflammatory absorption occurred. The data were tested by 蠂 2 test with spss13.0 software package. Results: after replantation for 18 m, the success rate was 46.2 in the experimental group and 84.6 in the control group. Conclusion: 1. Vitapex, a compound preparation of calcium hydroxide and calcium hydroxide, was used as a temporary root canal filling material in the treatment of total dislocation teeth with long time in vitro and poor preservation conditions. As a temporary root canal filling material, it is effective and safe to prevent root resorption. It is worth popularizing in the treatment of permanent pulp for total dislocation. 2. If the total permanent teeth with unclosed apical teeth were not preserved in the ideal medium for more than 1 hour, or the teeth were seriously polluted, the success rate of conservative treatment and replantation was significantly lower than the average level. New treatment methods and methods should be considered to improve the success rate of replantation.
【學(xué)位授予單位】：上海交通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R783.6

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相關(guān)期刊論文 前2條

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