关键词: 复杂冠根折, 断冠再粘接, 活髓切断, 年轻恒牙, 生存分析

Abstract:

Objective This study aimed to evaluate the clinical efficacy of pulpotomy combined with fragment reattachment in treating complicated crown-root fractures of maxillary young permanent anterior teeth. Methods A retrospective analysis of 37 cases of complicated crown-root fractures treated at Shenzhen Children’s Hospital from January 2019 to December 2023 was conducted. Outcomes such as fragment retention rate, pulp survival rate, root development, and periodontal health were assessed, and the influencing factors were analyzed. Results The fragment retention rates were 80.9% at 1 year and 69.5% at 2 years. The remaining crown height (cervical half group vs. incisal half group) emerged as a critical predictor of retention (P<0.05, hazard ratio=7.45, 95% confidence interval: 1.28-43.48). The pulp survival rate reached 91.6% at 1 year, with no significant influencing factors identified. In cases where the fractured crown retained for over one year, teeth at Nolla stage 8 showed significantly greater root elongation and apical foramen narrowing compared to those at Nolla stage 9 (P<0.05), normal periodontal scores were observed in 59.3%. Conclusion Pulpotomy combined with fragment reattachment effectively preserves pulp vitality and restores dental function and morphology in young permanent anterior teeth. The remaining crown height serves as a key prognostic indicator for fragment retention. This approach also promotes root development and demonstrates favorable clinical outcomes.

Key words: complicated crown-root fracture, fragment reattachment, pulpotomy, young permanent teeth, survival analysis