Replantation of 400 avulsed permanent incisors. 2. Factors related to pulpal healing.
Replantation of 400 avulsed permanent incisors. 2. Factors related to pulpal healing.
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DOI：
10.1111/j.1600-9657.1995.tb00462.x
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发表时间：
1995-04
期刊：
影响因子：
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通讯作者：
J. Andreasen;M. Borum;Henrik Jacobsen;F. Andreasen
中科院分区：
文献类型：
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作者：
J. Andreasen;M. Borum;Henrik Jacobsen;F. Andreasen
对400颗撕脱再植的恒牙进行了牙髓愈合情况的检查。110颗牙根尖孔开放或半开放。16颗牙行牙髓摘出术。因此，94颗牙齿的牙髓血运重建被认为是可能的。血运重建32颗牙（34%）。牙髓坏死通常在3周后出现。通常在6个月后观察到牙髓敏感性阳性和髓管闭塞的X线照片迹象。各种临床因素的影响进行了检查，如性别，年龄，类型的牙齿再植，根形成阶段，类型和长度的牙槽外存储，临床污染的根面，类型的根面清洁程序，类型和长度的夹板和抗生素的使用。最后，根尖孔的宽度和根管的长度进行了测量，在受伤时拍摄的X线片。多因素统计分析显示，牙髓血运重建在根尖孔到髓角距离较短的牙齿中更常见。此外，湿储存（唾液和/或生理盐水）超过5分钟，减少了牙髓血运重建的机会，而干牙槽外存储有一个单调的影响，牙髓血运重建的机会，即减少随着牙槽外干存储的长度增加。根据这些发现，建议在自来水或生理盐水中短暂清洗后立即再植。
Four hundred avulsed and replanted permanent teeth were examined for pulpal healing. In 110 teeth, the apical foramen was either open or half-open. In 16 teeth, the pulps were extirpated prophylactically. Thus, pulpal revascularization was considered possible in 94 teeth. Revascularization occurred in 32 teeth (34%). Pulp necrosis could usually be demonstrated after 3 weeks. Positive pulpal sensibility and radiographis signs of pulp canal obliteration were usually observed after 6 months. The effect of various clinical factors was examined, such as sex, age, type of tooth replanted, stage of root formation, type and length of extra-alveolar storage, clinical contamination of the root surface, type of cleansing procedure of the root surface, type and length of splinting and the use of antibiotics. Finally, the width of the apical foramen and the length of the root canal were measured on radiographs taken at the time of injury. A multivariate statistical analysis revealed that pulpal revascularization was more frequent in teeth with shorter distances from the apical foramen to the pulp horns. Furthermore, that wet storage (saliva and/or saline) for more than 5 min decreased the chance of pulpal revascularization; whereas dry extraalveolar storage had a monotonous effect on pulpal revascularization, i.e. decreasing chance of revasculatization with increasing length of the extraalveolar dry storage. Based on these findings, immediate replantation after brief cleansing in either tap water or saline is recommended.