多学科联合诊治儿童上前牙复杂冠根折1例

doi:10.7518/hxkq.2024.2023342

华西口腔医学杂志 ›› 2024, Vol. 42 ›› Issue (2): 249-255.doi: 10.7518/hxkq.2024.2023342

多学科联合诊治儿童上前牙复杂冠根折1例

张百泽(), 陈宇江, 王军辉, 刘佳佳, 吴礼安()

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，陕西省口腔疾病临床医学研究中心，第四军医大学口腔医院儿童口腔科，西安 710032

收稿日期:2023-10-12 修回日期:2024-02-20 出版日期:2024-04-01 发布日期:2024-03-26
通讯作者: 吴礼安 E-mail:zhangbaize@126.com;lianwu@fmmu.edu.cn
作者简介:张百泽，主治医师，硕士，E-mail：zhangbaize@126.com
基金资助:
国家自然科学基金青年项目(82100954)

One case of complicated crown root fracture of upper anterior teeth managed by multidisciplinary joint approaches

Zhang Baize(), Chen Yujiang, Wang Junhui, Liu Jiajia, Wu Li’an()

State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Dept. of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China

Received:2023-10-12 Revised:2024-02-20 Online:2024-04-01 Published:2024-03-26
Contact: Wu Li’an E-mail:zhangbaize@126.com;lianwu@fmmu.edu.cn
Supported by:
The National Natural Science Foundation Youth Program of China(82100954)

摘要/Abstract

摘要：

复杂冠根折是牙外伤中一类累及牙髓的釉质-牙本质-牙骨质联合折断，治疗方法复杂，过程中需综合考虑牙髓、牙周及牙体情况，进行多学科联合序列治疗。本病例报道了1例上前牙复杂冠根折后2颗患牙不同的治疗修复过程，包括初诊时翻瓣术后11牙的断冠再接和21牙腭侧去除断裂碎片直接树脂修复，以及复诊时11、21牙的牙髓治疗及冠部修复，经过18个月的随访，患牙的功能及牙周状况维持良好，美观性也得到了患儿及家长的肯定。对于儿童复杂冠根折上前牙，断冠再接及桩冠修复是一种可行的治疗方案。

关键词: 复杂冠根折, 断冠再接, 龈壁提升术, 桩冠修复, 全瓷冠

Abstract:

Complicated crown root fracture is a serious combined fracture of the enamel, dentin, and cementum in dental trauma. The treatment method is complicated. During the procedure, the condition of pulp, periodontal, and tooth body should be thoroughly evaluated, and a multidisciplinary approach combined with sequential treatment is recommended. This case reported the different treatment and repair processes of one case of two affected teeth after complicated crown root fracture of upper anterior teeth, including regrafting of broken crown after flap surgery at the first visit, direct resin repair to remove broken fragments, and pulp treatment and post-crown repair at the second visit. After 18 months of follow-up, the preservation treatment of the affected teeth with complicated crown root fracture was achieved. Therefore, fragment reattachment and post-crown restoration are feasible treatment options for children with complicated crown root fracture.

Key words: complicated crown root fracture, fragment reattachment, deep margin elevation, post-crown restoration, all-ceramic crown

中图分类号:

R788

张百泽, 陈宇江, 王军辉, 刘佳佳, 吴礼安. 多学科联合诊治儿童上前牙复杂冠根折1例[J]. 华西口腔医学杂志, 2024, 42(2): 249-255.

Zhang Baize, Chen Yujiang, Wang Junhui, Liu Jiajia, Wu Li’an. One case of complicated crown root fracture of upper anterior teeth managed by multidisciplinary joint approaches[J]. West China Journal of Stomatology, 2024, 42(2): 249-255.

图/表 5

图 1

图 2

图 3

图 4

图 5

参考文献 28

1	Castro JC, Poi WR, Manfrin TM, et al. Analysis of the crown fractures and crown-root fractures due to dental trauma assisted by the Integrated Clinic from 1992 to 2002[J]. Dent Traumatol, 2005, 21(3): 121-126.
2	Huang C, Yang Y, Wang Z, et al. A retrospective study of emergent traumatic dental injuries in permanent teeth in Xi’an, China[J]. Medicine (Baltimore), 2022, 101(52): e32588.
3	刘佳佳, 王小竞. 年轻恒牙复杂冠折及冠根折的诊疗策略[J]. 中国实用口腔科杂志, 2022, 15(4): 405-410.
	Liu JJ, Wang XJ. Diagnosis and treatment strategies of complicated crown fracture and crown-root fracture of young permanent teeth[J]. Chin J Pract Stomatol, 2022, 15(4): 405-410.
4	Chandra RV, Savitharani B, Reddy AA. Comparing the outcomes of incisions made by colorado microdissection needle, electrosurgery tip, and surgical blade during periodontal surgery: a randomized controlled trial[J]. J Indian Soc Periodontol, 2016, 20(6): 616-622.
5	Wang C, Jia XT, Zhen M, et al. Success rate of fractured teeth receiving modified crown lengthening surgeryand restorations[J]. BMC Oral Health, 2022, 22(1): 99.
6	Radwanski M, Caporossi C, Lukomska-Szymanska M, et al. Complicated crown fracture of permanent incisors: a conservative treatment case report and a narrative review[J]. Bioengineering (Basel), 2022, 9(9): 481.
7	Villat C, Machtou P, Naulin-Ifi C. Multidisciplinary approach to the immediate esthetic repair and long-term treatment of an oblique crown-root fracture[J]. Dent Traumatol, 2004, 20(1): 56-60.
8	Cavalleri G, Zerman N. Traumatic crown fractures in permanent incisors with immature roots: a follow-up study[J]. Endod Dent Traumatol, 1995, 11(6): 294-296.
9	Soliman S, Lang LM, Hahn B, et al. Long-term outcome of adhesive fragment reattachment in crown-root fractured teeth[J]. Dent Traumatol, 2020, 36(4): 417-426.
10	Lakshmaiah D, Sr V, Ilango S, et al. Management of complex crown fractures: a case series[J]. Cureus, 2023, 15(4): e37907.
11	Bissinger R, Müller DD, Hickel R, et al. Survival analysis of adhesive reattachments in permanent teeth with crown fractures after dental trauma[J]. Dent Traumatol, 2021, 37(2): 208-214.
12	房志秀, 赵磊, 张新新. 原位断端再接技术在儿童年轻恒前牙复杂冠根折中的应用[J]. 系统医学, 2023, 8(5): 162-165, 170.
	Fang ZX, Zhao L, Zhang XX. Application of in situ stump rejoining technique in complex crown root compromise of young permanent anterior teeth in children[J].Systems Med, 2023, 8(5): 162-165, 170.
13	薛亮, 丁谦文, 张昕. 斜行复杂冠根折保存断冠序列治疗的临床疗效评价[J]. 北京口腔医学, 2018, 26(4): 216-219.
	Xue L, Ding QW, Zhang X. Clinical evaluation of sequential therapy for complicated oblique crown-root fractures[J]. Beijing J Stomatol, 2018, 26(4): 216-219.
14	Castelo-Baz P, Argibay-Lorenzo O, Muñoz F, et al. Periodontal response to a tricalcium silicate material or resin composite placed in close contact to the supracrestal tissue attachment: a histomorphometric comparative study[J]. Clin Oral Investig, 2021, 25(10): 5743-5753.
15	Juloski J, Köken S, Ferrari M. Cervical margin relocation in indirect adhesive restorations: a literature review[J]. J Prosthodont Res, 2018, 62(3): 273-280.
16	Dietschi D, Spreafico R. Evidence-based concepts and procedures for bonded inlays and onlays. PartⅠ. Historical perspectives and clinical rationale for a biosubstitutive approach[J]. Int J Esthet Dent, 2015, 10(2): 210-227.
17	Dietschi D, Spreafico R. Evidence-based concepts and procedures for bonded inlays and onlays. Part Ⅲ. A case series with long-term clinical results and follow-up[J]. Int J Esthet Dent, 2019, 14(2): 118-133.
18	Jepsen S, Caton JG, Albandar JM, et al. Periodontal ma-nifestations of systemic diseases and developmental and acquired conditions: consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Pe-riodontal and Peri-Implant Diseases and Conditions[J]. J Clin Periodontol, 2018, 45(): S219-S229.
19	孟秀萍, 侯建华, 李怡然, 等. 龈壁提升术材料选择及边缘设计的研究进展[J]. 国际口腔医学杂志, 2021, 48(3): 280-286.
	Meng XP, Hou JH, Li YR, et al. Research progress on the selection and design of base materials in deep margin elevation[J]. Int J Stomatol, 2021, 48(3): 280-286.
20	Da Silva D, Ceballos L, Fuentes MV. Influence of the adhesive strategy in the sealing ability of resin composi-te inlays after deep margin elevation[J]. J Clin Exp Dent, 2021, 13(9): e886-e893.
21	Alahmari NM, Adawi HA, Moaleem MMA, et al. Effects of the cervical marginal relocation technique on the marginal adaptation of lithium disilicate CAD/CAM ceramic crowns on premolars[J]. J Contemp Dent Pract, 2021, 22(8): 900-906.
22	Beit P, Konstantonis D, Papagiannis A, et al. Vertical skeletal changes after extraction and non-extraction treatment in matched classⅠpatients identified by a discriminant analysis: cephalometric appraisal and Procrustes superimposition[J]. Prog Orthod, 2017, 18(1): 10-44.
23	Meyer AH, Woods MG, Manton DJ. Maxillary arch wid-th and buccal corridor changes with orthodontic treatment. Part 1: differences between premolar extraction and nonextraction treatment outcomes[J]. Am J Orthod Dentofacial Orthop, 2014, 145(2): 207-216.
24	Sulaiman TA, Abdulmajeed AA, Delgado A, et al. Fracture rate of 188 695 lithium disilicate and zirconia cera-mic restorations after up to 7.5 years of clinical service: a dental laboratory survey[J]. J Prosthet Dent, 2020, 123(6): 807-810.
25	林泓磊, 李麒, 于皓, 等. 不同颜色与厚度的2种玻璃陶瓷修复体对光固化灯透射光学性能的影响[J]. 上海口腔医学, 2020, 29(1): 13-18.
	Lin HL, Li Q, Yu H, et al. Optical properties of LED light curing unit before and after transmitting different colors and thickness of two kinds of glass ceramics[J]. Shanghai J Stomatol, 2020, 29(1): 13-18.
26	丁婕, 李娟, 王思明. 铸瓷贴面用于前牙美容修复效果的影响因素分析[J]. 湖南师范大学学报(医学版), 2020, 17(5): 129-131.
	Ding J, Li J, Wang SM. Influencing factors of cast porcelain veneers cosmetic restoration of anterior teeth[J].J Hunan Normal Univ (Med Sci), 2020, 17(5): 129-131.
27	Jurema ALB, Filgueiras AT, Santos KA, et al. Effect of intraradicular fiber post on the fracture resistance of en-dodontically treated and restored anterior teeth: a systematic review and meta-analysis[J]. J Prosthet Dent, 2022, 128(1): 13-24.
28	陈志宇, 李雅, 李绍萍, 等. 一体化纤维桩核结合原全冠修复折断前牙的3年临床观察[J]. 北京口腔医学, 2022, 30(3): 195-198.
	Chen ZY, Li Y, Li SP, et al. Restoration of fractured anterior teeth crown by one-piece fiber post-and-core and the original crown:a 3 years of retrospective evaluation[J]. Beijing J Stomatol, 2022, 30(3): 195-198.

[1]	李思诺, 张璐瑶, 梁珊珊, 刘玉强, 邢文忠. 瓷材料种类及厚度对椅旁可切削全瓷冠遮色能力的影响[J]. 华西口腔医学杂志, 2024, 42(1): 56-61.
[2]	张英. 复杂冠根折的治疗策略[J]. 华西口腔医学杂志, 2017, 35(5): 456-460.
[3]	占莉琳曾利伟陈萍廖岚李十月刘仁英. 不同数字印模方式影响全瓷冠边缘适合性的研究[J]. 华西口腔医学杂志, 2015, 33(4): 401-404.
[4]	钟倩周国兴光寒冰戴文雍邱憬王国平朱志军汤春波 . 个性化铸瓷复合基台在前牙种植美学修复中的临床应用[J]. 华西口腔医学杂志, 2013, 31(4): 429-431,433.
[5]	胡建1 章非敏1 戴宁2 李泷杲2 顾卫平1 马骏驰1. 不同厚度上颌中切牙全瓷冠应力分布的有限元研究[J]. 华西口腔医学杂志, 2012, 30(4): 356-359.
[6]	石巧云镇荣军. 自体前牙断冠再接的临床疗效[J]. 华西口腔医学杂志, 2011, 29(02): 171-172.
[7]	谭发兵王璐付钢吴树洪金萍. 不同光学印模法对全瓷冠边缘和内部适合性影响的实验研究[J]. 华西口腔医学杂志, 2010, 28(01): 29-33.
[8]	魏煦李彦. 下颌切牙Empress 2瓷贴面与全瓷冠牙预备体及全瓷修复复合体的抗折裂研究[J]. 华西口腔医学杂志, 2009, 27(06): 622-625.
[9]	赵煜;姚蔚;陈新民;巢永烈. 根管治疗后邻(牙合)面缺损前磨牙修复方式的生物力学研究[J]. 华西口腔医学杂志, 2006, 24(01): 26-28.

多学科联合诊治儿童上前牙复杂冠根折1例

One case of complicated crown root fracture of upper anterior teeth managed by multidisciplinary joint approaches

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 5

参考文献 28

相关文章 9

编辑推荐

Metrics

本文评价