Treatment of vertically fractured root with advanced periodontal breakdown by bonding and replantationmethod in combination with the periodontal regenerative therapy.

牙根垂直骨折会导致牙周深度破裂和垂直骨缺损。本研究的目的是探讨结合牙周再生治疗方法治疗重度牙周破裂的垂直折根。我们首先用4只小猎犬进行临床和病理研究，研究了垂直根骨折后牙周破坏的过程。结果表明，即使探牙深度相当大，在骨折早期，附着丧失是最小的，而根管内的细菌等刺激性物质会引起牙周组织的炎症。随后沿骨折部位失去附着物，牙周破坏进展，菌斑在牙根表面积聚。第二项研究是比较口腔内粘接治疗与口腔外粘接再种植治疗对垂直根骨折牙周愈合的临床和病理效果。上述结果提示，口腔外粘接治疗后牙周炎症和炎症根吸收明显小于口腔内粘接治疗，仅口腔外粘接治疗后出现强直。第三项研究是比较口腔外粘接和再植治疗与粘接和旋转再植治疗后牙周愈合的病理差异。结果表明：对于重度牙周破裂的牙根垂直断裂，牙周袋缩小，粘接旋转再植治疗是有效的。从调查结果来看，诊断纵根骨折的牙周破坏阶段是很重要的。结果表明，口腔外结合旋转再植治疗重度牙周破坏的牙根纵裂是有效的。

Vertical root fractures lead to advanced periodontal breakdown with deep periodontal pockets and vertical bone defects. The purpose of this investigation was to study the treatment of vertically fractured root with advanced periodontal breakdown by bonding and replantation method in combination with the periodontal regenerative therapy.1. At first, we studied the process of periodontal destruction after vertical root fracture using 4 beagles in clinically and pathologically. Results showed that attachment loss was minimal in the early fracture stage even if probing depth was considerable, and irritants such as bacteria in the root canal induced inflammation of periodontal tissues. Attachment was later lost along the fracture site and periodontal destruction progressed with plaque accumulating on root surface.2. The second study was to compare the periodontal healing after performing the intra-oraly bonding treatment with that of the extra-orally bonding and replanted treatmetn for vertical root fracture in clinically and pathologically. These findings thus indicated that periodontal inflammation and inflammatory root resorption after extra-orally bonding treatment was significantly smaller than that of intra-orally bonding treatment, and ankylosis was observed only extra-orally bonding treatment.3. The thrid study was to compare the periodontal healing after performing the extra-orally bonding and replanted treatment with the bonding and rotational replantation treatment in pathologically. The results showed that the bonding and rotational replantation treatment was effective for vertically fractured root with advanced periodontal breakdown to periodontal pocket reduction.From the result of investigations, it is important to diagnose the stage of periodontal destruction of vertical root fracture. It became clear that the extra-orally bonding and rotational replantation treatment method for vertical root fracture with advanced periodontal destruction is effective.