下前牙牙骨质撕裂1例

doi:10.3877/cma.j.issn.1674-1366.2022.06.007

中华口腔医学研究杂志(电子版) ›› 2022, Vol. 16 ›› Issue (06) : 378 -381. doi: 10.3877/cma.j.issn.1674-1366.2022.06.007

病例分析

下前牙牙骨质撕裂1例

房俊艳¹, 贾云飞¹, 黄爱红¹, 宋永海²^,^†(

)

^1. 淄博市第九人民医院·桓台县人民医院口腔科，淄博　256400
^2. 淄博市中心医院口腔颌面外科，淄博　255036

收稿日期:2022-07-16 出版日期:2022-12-01
通信作者: 宋永海

The mandibular anterior tooth with cemental tear: A case report

Junyan Fang¹, Yunfei Jia¹, Aihong Huang¹, Yonghai Song²^,^†()

^1. Department of stomatology, Zibo Ninth People′s Hospital · Huantai County of People′s Hospital, Zibo 256400, China
^2. Department of Oral and Maxillofacial Surgery, Zibo Central Hospital, Zibo 255036, China

Received:2022-07-16 Published:2022-12-01
Corresponding author: Yonghai Song

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牙骨质撕裂是牙骨质沿牙骨质牙本质界或牙骨质沉积层破坏分离的现象。牙骨质撕裂病例临床较少见，多数通过X线检查发现，本文报道下前牙牙骨质撕裂1例。医生在临床中应甄别牙骨质撕裂与牙髓根尖周病、牙周病，做好X线片判读，必要时进行锥形束CT检查以明确诊断。

关键词: 牙骨质撕裂, 牙骨质,

创伤

A cemental tear is the detachment of the cementum from the cemento-dentinal junction or along the lamellar structure within the body of cementum. Case reports on cemental tears are rare and most of the cases are found during the X-ray examination. This case report presents a mandibular incisor with cemental tear. Doctors should distinguish cemental tear, pulp-periapical disease and periodontal disease in clinical practice, perform a good X-ray interpretation cone-beam CT examination when necessary to make a clear diagnosis.

Key words: Cemental tear, Cementum, Occlusal trauma

图1 下牙牙骨质撕裂患者初诊时全颌曲面断层片　16、25、36、45、46、47缺失，31、41先天性缺失，42根管内高密度影，牙周膜影像增宽，根尖周片状骨质密度增高区。

图2 下牙牙骨质撕裂患者根尖X线片　42根尖1/3处近中牙骨质部分裂开、牙槽骨角形吸收，远中牙骨质呈片状全完分离、牙槽骨呈圆弧形吸收，牙根近中冠方牙周膜影像增宽。

图3 下牙牙骨质撕裂患者牙胶尖示踪法锥形束CT（CBCT）影像　A：冠状面观根尖1/3处近中及远中片状骨质高密度；B：水平面观根尖1/3处有围绕牙根一周的骨质密度增高影像；C：矢状面观感染指向根尖骨质低密度区，患牙根尖周组织破坏严重。

图4 下牙牙骨质撕裂患者42牙龈翻瓣术及拔除　A：翻瓣后见唇侧根尖1/3处牙骨质片状剥脱；B：探及近中及远中牙骨质间隙，牙骨质与牙本质交界明显；C：42拔除后见拔牙窝颊侧、舌侧、近中、远中残留牙骨质碎片。

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