前牙龈下断根经正畸牵引后修复临床探究.doc

前牙龈下断根经正畸牵引后修复临床探究[摘要]目的：研究前牙断根至龈下经正畸牵引后的烤瓷桩冠修复方法。方法：选择26例前牙共30颗经完善根管治疗后，采用正畸牵引方法牵出牙根至龈上0.5cm或平齐龈缘，再固定3个月后行烤瓷桩冠修复。结果：30颗除1颗发生根折，1颗牙根松动，另有一颗有明显炎症外，其余牙修复效果均较满意。结论：前牙龈下断根行正畸牵引后再修复既保留了常规应拔除的牙根又可获得较好的功能和美学效果。 [关键词]断根；正畸牵引；修复 [中图分类号]R783.5 [文献标识码]A [文章编号]1008-6455（2008）10-1495-02 The clinical study of the anterotooth subgirgival crown fracture after orthodontic protraction DING Shuang-ying,JIANG Yu-feng,KONG Fan-zhi,SHE Peng (Department ofStamotology,the First Affiliated People’s Hospital of Zhenjiang, Jiangsu University,Zhenjiang, 212002,Jiangsu,China) Abstract:ObjectiveThe purpose of this study was to evaluate the application of orthodontic treatment before anterior teeth restoration when the location of root fracture was below the gingival margin.Methodsthe study used 30 anterior tooth roots of 26 patients which had treated by RCT. They were extracted between 0mm and 0.5mm by orthodontic traction method, and were restored by dowel crown after 3 months. Results Three failed in the 30 cases. One was found root fracture in other places, one was loosing, and another was inflammation. The rest of patients was satisfied with the results. ConclusionThe orthodontic treatment for root fracture anterior tooth can not only preserve the root that should be extracted conventionally, but also acquire the function and the esthetics of the restoration. Key words:fractured rots of preterior teth;orthodontic traction;Repair 临床上经常会遇到因外伤而根折于龈下的患者。若断根面至龈缘不超过2cm，一般采用龈切术或冠延长术保留牙根，但这两者都可能引起美观或牙龈的问题。笔者于近5年采用先行正畸牵引断根再进行桩冠修复的方法，共治疗患牙26颗，取得了良好的效果。 1材料和方法 1.1一般资料：选择前来就诊的前牙外伤根折至龈下1～3.5mm的患者26例(男14例，女12例),年龄16～46岁。共30颗患牙，中切牙15颗，侧切牙13颗，尖牙2颗。牙龈组织健康，经完善根管治疗。 1.2方法：①上前牙龈下牙根正畸牵引前常规摄牙根尖片，了解牙根尖周及根管情况。经完善而彻底的根管治疗后，观察2周，然后在根管内粘固0.9mm钢丝弯制的牵引钩，长度应小于根长的一半。②在患牙两侧3～4个邻牙上粘结标准方丝弓托槽，用0.46mm的澳丝按照牙弓外形弯制唇弓，使唇弓通过断根的中间并与牙根长轴垂直再做一小V形曲，以免牵引的牙根发生倾斜。如果患者断根处缺隙小或前牙排列明显不整齐，可先排齐整平牙齿并开拓足够间隙，使缺牙处间隙与临近同名牙冠宽度一致。③将粘固在根管内的牵引钩与唇弓用弹力线测力,力值为50g时连接，使龈下牙根牙合向萌出牵引。④4～6周后，牙根萌出平齐龈缘或龈上0.5cm位置后，去掉弹力线，改用金属结扎丝固定