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題名 | 根管治療後牙齒垂直牙根斷裂的特徵分析=Analysis of Characteristics of Vertical Root Fracture in Endodontically Treated Teeth |
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作者 | 蔡宜玲; 林俊彬; 陳朝寶; 藍萬烘; Tsai, Yi-ling; Lin, Chun-pin; Chan, Chiu-po; Lan, Wan-hong; |
期刊 | 中華牙醫學雜誌 |
出版日期 | 20010300 |
卷期 | 20:1 2001.03[民90.03] |
頁次 | 頁11-20 |
分類號 | 416.9492 |
語文 | chi |
關鍵詞 | 垂直牙根斷裂; 根管治療; Vertical root fracture; Endodontic treatment; |
中文摘要 | 垂直牙根斷裂(vertical root fracture)是臨床上常見且棘手的問題。過去國內學者所提出之臨床調查報告多為未接受過根管治療的牙齒,國外則正好相反。本研究目的在於分析國人根管治療後發生垂直牙根斷裂病例的特徵。選取因垂直牙根斷裂而必須拔除的牙齒76顆(共83個牙根),將之分組:A組-無柱(post)、牙體復形;B組-無柱、以牙冠牙橋復形;C組-有柱、以牙冠牙橋復形。再以立體顯微鏡觀察裂紋之特徵,並依病患之性別及年齡、斷裂牙齒類別、牙根位置、裂紋走向、以及裂紋與牙冠邊緣之距離等項目加以分析比較。 結果顯示,接受過根管治療且有牙冠牙橋復形的牙齒仍會發生垂直牙根斷裂,顯示補綴物可能無法避免這一類斷裂的發生。此外,裂紋較常出現於牙根直徑較粗的頰舌側(95%),其出現的位置可能在頰側、舌側、或頰舌兩側都有,這使得以手術診斷及治療時必須兩側兼顧,才能避免誤診或延誤病情,也使得診療更為困難。我們也發現,以牙冠或牙橋復形之B組及C組當中,有不少樣本之裂紋直接與牙冠邊緣相連,但僅以牙體復形之A組則無此現象。顯示牙本質牙釉質交界區域(DEJ zone)可能具有阻擋斷裂延伸的功能。 |
英文摘要 | Vertical root fracture (VRF) is a common dental problem. Most local surveys of vertical root fractures have focused on non-endodontically treated teeth. In contrast, overseas reports focused almost invariably on endodontically treated teeth. The purpose of this study was to investigate the characteristics of VRF in endodontically treated teeth. Seventy-six teeth (83 roots) were included in this study. The patients' dental history, clinical presentations, and radiographic findings were recorded. Fractured teeth were divided into three groups: Group A- operative restoration without a post; Group B- crown or bridge reconstruction without a post; Group C-crown or bridge reconstruction with a post. Stereomicrographic observation was used to determine the possible sites and directions of crack initiation and propagation. Finally, all collected data were analyzed with data analysis software and an image processing system. The results showed that most vertical root fractures occurred in endodontically treated teeth with crown or bridge reconstruction. It implies that restoration such as full crowns or bridges do not prevent VRF. Moreover, fractures primarily occurred in the buccal-lingual planes of roots (95%). The fractures were found on buccal or lingual surfaces, or both. We also found that most fractures extended to reconstructed crown margins in group B and C, but in Group A, fractures never extended to within 1 mm of the CEJ (cementoenamel junction). It appears that DEJ (dentinoenamel junction) may play an important role in preventing crack propagation. |
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