恒牙外伤根折牙的愈合方式与治疗策略

doi:10.3877/cma.j.issn.1674-1366.2024.05.002

中华口腔医学研究杂志(电子版) ›› 2024, Vol. 18 ›› Issue (05) : 295 -299. doi: 10.3877/cma.j.issn.1674-1366.2024.05.002

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恒牙外伤根折牙的愈合方式与治疗策略

刘艳丽¹, 陈永进¹^,^†(

)

^1. 口颌系统重建与再生全国重点实验室，国家口腔疾病临床医学研究中心，陕西省口腔医学重点实验室，第四军医大学口腔医院急诊与综合临床科，西安　710032

收稿日期:2024-06-29 出版日期:2024-10-01
通信作者: 陈永进

Prognosis assessment and treatment measures for permanent tooth trauma with root fracture

Yanli Liu¹, Yongjin Chen¹^,^†()

^1. State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of General Dentistry & Emergency, School of Stomatology, The Fourth Military Medical University, Xi′an 710032, China

Received:2024-06-29 Published:2024-10-01
Corresponding author: Yongjin Chen
Supported by:
Key Research and Development Program of Shaanxi Province(2023-YBSF-609)

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恒牙根折是牙外伤常见类型之一，其预后受诸多因素影响，大多数观点认为拔牙是其主要治疗方案。然而，随着对根折牙愈合的生物学基础的深入认识，国际牙外伤协会（IADT）在2020年发布的新版牙外伤指南中提出了不同看法，牙髓完整、牙周基础条件好的根折牙，根折线处硬组织愈合发生率非常高，通过适当的临床措施，根折牙可以达到保留天然牙的目标。本文在文献查阅基础上系统阐述了根折牙愈合的生物学基础、愈合方式，以及根折牙的治疗策略。

关键词: 根折, 硬组织愈合, 结缔组织愈合, 炎性愈合, 天然牙保存

Permanent root fracture is a prevalent form of dental trauma, and its prognosis is influenced by numerous factors. While tooth extraction is commonly considered as the primary treatment option, the new dental trauma guidelines released by the International Association of Dental Trauma (IADT) presents a different perspective. For teeth with fractured root but intact pulp and good periodontal condition, hard tissue healing is probably to occur at the fracture line, so that they are likely to be preserved through appropriate clinical measures. This article systematically elucidated the biological basis, mechanisms of healing, and treatment strategies for teeth with fractured root based on a comprehensive literature review.

Key words: Fracture, tooth root, Hard tissue healing, Connective tissue healing, Inflammatory healing, Tooth preservation

图1 恒牙根折与愈合方式示意图　A：根折；B：硬组织愈合；C：结缔组织愈合；D：骨和结缔组织愈合；E：炎性愈合或未愈合。

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