Fracture Necrosis: Diagnosis, Prognosis Assessment, and Treatment Recommendations
Fracture Necrosis: Diagnosis, Prognosis Assessment, and Treatment Recommendations
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DOI：
10.1016/j.joen.2009.12.018
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发表时间：
2010-03-01
影响因子：
4.2
通讯作者：
Kuttler, Sergio
中科院分区：
文献类型：
--
作者：
Berman, Louis H.;Kuttler, Sergio
前言：牙齿中存在的裂缝和骨折会给诊断、预后评估和治疗建议带来困难。如果牙齿没有明显的修复体或龋齿，因此牙髓在没有脱位损伤的情况下是不重要的，那么这种坏死很可能是由从咬合面延伸到牙髓的重大纵裂引起的。这种类型的表现被称为“骨折坏死”。方法：对27颗无活力牙髓、未修复或微深修复体、无龋病征象的患牙进行评估。这些牙齿被拔除，并根据任何潜在骨折的深度和位置进行评估。结果：所有被评估的牙齿都有从咬合面延伸到牙髓并延伸到牙根外表面的裂隙。结论：在没有修复体、龋齿或脱位损伤的情况下，牙髓坏死很可能是由从咬合面延伸到牙髓的纵向骨折引起的。根据现有的文献，这些类型的牙齿在根管治疗后预后可能很差，可能会导致广泛的牙周和/或根尖周骨丢失。摘除可以被认为是主要的治疗选择。(J Endod 2010；36：442-446)
Introduction: The presence of cracks and fractures in teeth can pose difficulties in diagnosis, prognosis assessment, and treatment recommendations. When a tooth has no significant restorations or caries, whereby the pulp is nonvital in the absence of a luxation injury, it is suggested that this necrosis is likely caused by a significant longitudinal crack that extends from the occlusal surface and into the pulp. This type of presentation has been termed "fracture necrosis." Methods: Twenty-seven teeth with nonvital pulps were evaluated that had no restorations or minimally deep restorations and no signs of caries. These teeth were extracted and evaluated as to the depth and location of any potential fracture. Results: All evaluated teeth were found to have cracks that extended from the occlusal surface into the pulp and progressed to an external root surface. Conclusion: Pulp necrosis, in the absence of restorations, caries, or luxation injuries, is likely caused by a longitudinal fracture extending from the occlusal surface and into the pulp. Based on the available literature, these types of teeth may have a poor prognosis after endodontic treatment, with the potential ramification of extensive periodontal and/or periapical bone loss. Extraction may be considered as the primary treatment option. (J Endod 2010;36:442-446)