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題 名 | 外傷脫落之門齒在失去牙髓活性後牙根繼續發育--病例報告=Continued Root Development after Avulsion and Pulp Necrosis of Young Permanent Incisor: A Case Report |
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作 者 | 李盈欣; 陳亮如; 陳惠鈴; 劉正芬; 羅信義; | 書刊名 | 臺灣兒童牙醫學雜誌 |
卷 期 | 9:1 2009.04[民98.04] |
頁 次 | 頁21-26 |
分類號 | 417.6943 |
關鍵詞 | 外傷脫落; 開放性根尖; 血流再重建; 根尖成形術; Avulsion; Open apex; Re-vasculization; Apexification; |
語 文 | 中文(Chinese) |
中文摘要 | 牙根未發育完全的牙齒受到外傷後,若是牙髓壞死,則選擇的治療方式為根尖成形術,以氫氧化鈣放置根管內,誘導根尖出現鈣化屏障,但牙根不會再繼續生成。若牙髓未發生壞死,則會以根尖生成術方式治療,以保持牙髓活性,促使牙根繼續發育完成。由於醫療技術的進步,近年來研究發現即使是牙髓壞死的牙齒,只要能維持根尖及赫威氏上皮根鞘部分的活性,根尖生成術也是可能的,也有人稱為血流再重新建立。本病例為一8歲男童因外傷造成右上正中門齒脫落,植回後因牙髓壞死,且牙根尖未發育完成,選擇以根尖成形術方式治療。但追蹤治療結果發現不僅如同根尖成形術般出現鈣化屏障,而且牙根依舊繼續發育,直到根尖閉合,根尖孔形成,如同進行根尖生成術。因而開放型根尖年輕恆牙即便因牙齒外傷導致牙髓壞死,如能維持赫威氏上皮根鞘及根尖部分的活性,仍是可達到血流重建而促使牙根繼續發育完成。 |
英文摘要 | Apexification is usually required to induce apical calcification in teeth with incomplete root development and necrotic pulp. Calcium hydroxide has been widely accepted as the material of choice to induce a hard tissue barrier. On the other hand, apexogenesis was only recommended as vital pulp therapy to remain pulp vitality and continue root development in teeth with vital pulp. There have been relatively few reports of continued root development when the pulp has become necrotic. As long as the periapical tissue, such as Hertwig's epithelial root sheath has not been complete destructed, the revascularization of pulp circulation may be re-established through the open apex of the immature teeth, allowing pulp survival and continued root development. This article presented an 8-year-old boy with an avulsed maxillary right central incisor. The pulp was necrotic and root formation was incomplete. Therefore, apexification was the treatment choice for this tooth. The tooth was treated with calcium hydroxide to induce calcified barrier formation at apical region. However, the treatment result was surprising, the root continually developed to the same length as that of contra-lateral tooth. This case report demonstrated not only calcified barrier formed like traditional apexification, but continued root development and apical constriction were also found like apexogenesis. Preservation of Hertwig's root sheath and vital apical tissue in young permanent tooth with open apex after trauma is essential for re-vascularization even the pulp is necrosis. |
本系統中英文摘要資訊取自各篇刊載內容。