根管内种植术治疗前牙根折的观察

王宝彦　苟建重　赵淑贤　张　兰

作者单位：西安医科大学口腔医学院口腔内科(西安710004)

摘要目的：为了保存牙根的前牙。方法：将根管内种植术治疗用于 149颗根折的前牙。结果：以过对3、5、7年组分析，显效率分别75%、71.43%和77.27%。 好转率分别为23.21%、22.45%和18.18%。失败率分别为1.79%、6.12%、4.55%。讨论 ：结果显示应用此方法有治疗快速、外形美观、合乎卫生、能够完整地保留根折牙齿使其继 续较好地发挥功能的优点。提示应当慎重选择牙根冠1/3折断的病例，重视牙周组织炎症的 治疗和牙折的急诊处理。

关健词前牙根折根管内种植

REALIZATIONS ABOUT APPLYING ENDOSSEOUS ENDODONTIC IMPLANTION

IN 149 FRONT TEETH WITH ROOT FRACTURE

Wang BaoyanGou JianzhongZhao ShuxianZhang Lan

Department of Oral Medicne Stomatological Collegfe Xian Medical Universit y

AbstractAim:In order to save anterior teeth with root fr acure.Method: An Endosseous endodontic implantation was used in 149 anterior t eeth with root fractureResults:It was reported in this paper that the curativeeffect was observed with follow-up in-groups of 3,5,to7years.The effective rateis 75%,71.43%and77.27%,the rate of mend is 23.21%,22.45%and 18.18%,the ineffect ive rate is 1.79%.6.12%and4.55%in3,5,7years.Discussion:The results show that t his method is quick,handsome,clean,and that the anterior teeth with root fractur e could be saved in function and structure entirely.It is supposed to be carefulthat the root fracture is located in coronal third of the root when endosseousendodontic implant was applied,and patients periodontal tissue inflammation oug ht to be cured.It is necessary that emergent treatment of root fracture should b e put in Practice right and as soon as possible.

key words Antreior teethRoot fractureEndosseous endo dontic implant

前牙根折是常见的口腔疾病急症之一。由于根折发生的同时往往 伴有颌面部损伤，常常使根折牙的治疗被推迟、延误或遗漏，增加了保留根牙的难度，经常 因此而拔牙，影响了患者的容貌。自1989年以来我们采用根管内种植术治疗了根折前牙149 颗，经远期观察取得了满意的疗效，介绍如下。

1临床资料

本组93例共149颗前牙，男74例女27例，年龄17岁～76岁。其中15颗牙的根折线 位于牙根颈部与中1/3之间；11个牙的根折线与龈沟或牙周袋相通。

2方法

根管内种植器械按要求消毒备用^〔1〕；开髓孔应靠近牙齿切缘，根据情 况将牙髓腔在术前预先消毒或在术中拔除牙髓、制备根管；使开髓孔-根尖孔-骨内钉道三者 成一直线；注意降温、保护患牙；根尖孔置放氢氧化钙糊剂、选择合适的固位钉，以磷酸 锌水门汀粘固粉粘固，植入种植钉时要防止牙折片冠向脱位；调整咬合、充填开髓孔；术后 局部冷敷，酌情使用抗生素，定期复查。……