What is the Best Root Surface Treatment for Avulsed Teeth?
What is the Best Root Surface Treatment for Avulsed Teeth?
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DOI：
10.2174/1874210601408010175
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Yamamato S
中科院分区：
文献类型：
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作者：
Tuna EB;Yaman D;Yamamato S
牙齿撕脱是最严重的类型的创伤性牙齿损伤，因为它会导致几个结构的损坏，并导致牙齿从其插座撕脱。撕脱牙的治疗方案应包括牙髓和牙周膜（PDL）细胞的管理，以改善这些牙齿的长期预后和生存。治疗的预后以及撕脱牙的存活取决于内在和外在因素，例如牙槽外期的持续时间、再植时间、储存介质的类型、PDL状态和夹板固定的持续时间。最近的研究导致了存储介质的发展。然而，目前还没有一个单一的解决方案，满足所有的要求被认为是理想的介质暂时储存撕脱牙，并在这一领域的研究进行。另一方面，在延迟再植的情况下，由于撕脱后的牙齿丢失的风险很大，已经提出了不同的根表面处理，以防止和延迟牙根吸收再植前。为此，研究人员在撕脱牙延迟再植中应用了一些不同的根面处理方式。已经使用了几种方案来维持PDL活力;一些方案涉及氟化物、类固醇、阿仑膦酸钠、釉质基质衍生物（EMD）和碱性成纤维细胞生长因子（bFGF、FGF-2）。在这些应用中，bFGF在天然牙齿结构和组织的再生中显示出有希望的结果。深入了解bFGF的作用机制有助于促进牙体再生新技术的发展。
Dental avulsion is the most severe type of traumatic tooth injuries since it causes damage to several structures and results in avulsion of the tooth from its socket. Management protocols for avulsed teeth should include management of the pulp and periodontal ligament (PDL) cells in order to improve the long-term prognosis and survival of these teeth. The prognosis of the treatment as well as the survival of an avulsed tooth depends on intrinsic and extrinsic factors, such as the duration of the tooth’s extra-alveolar period, replantation time, the type of storage medium, PDL status and duration of splinting. Recent research has led to the development of storage media. However, there is not yet a single solution that fulfills all requirements to be considered as the ideal medium for temporary storage of avulsed teeth, and research on this field should carry on. On the other hand in case of delayed replantation, due to the great risk of tooth loss after avulsion, different root surface treatments have been proposed to prevent and delay root resorption before replantation. For this purpose, researchers have applied some different root surface treatment modalities in delayed replantation of avulsed teeth. Several protocols have been used to maintain PDL viability; some involve fluorides, steroids, sodium alendronate, enamel matrix derivatives (EMD) and basic fibroblast growth factor (bFGF, FGF-2). Among these applications, bFGF shows promising results in the regeneration of natural tooth structures and tissues. Better understanding of mechanism of bFGF may help to improve new technologies of regeneration of tooth structures.