背景:这项研究旨在评估16个永久性上颌中切牙的长期结果,这些切牙具有非生命性牙髓和开放的牙尖,并接受了根尖修复术和冠状神经根粘附修复术。在5到22年的随访时间内。
方法:14例患者共16颗牙齿用三氧化物矿物聚集体治疗(n=12),生物牙本质(n=3),或β-磷酸三钙(n=1)根尖屏障和冠状神经根恢复,有或没有玻璃纤维柱,包括在内。定义了召回时评估的临床和影像学标准。修复和根尖周组织状态评估根据FDI世界牙科联合会的美学,功能,生物学标准和Ørstavik根尖指数(PAI)。结果分为“已治愈”(PAI≤2,无症状,无感染迹象)或“未治愈”(PAI≥3,存在临床体征和/或症状)。
结果:24名患者中有14名可用于本研究(召回率=58%)。在5到22年的随访中,10颗(62.5%)牙齿被认为已经愈合,“满足严格的临床和影像学成功标准。只有1颗牙齿因牙根吸收而缺失,1例患者在回忆时出现临床体征和症状,成活率为93.8%。
结论:在不重要的恒生未成熟牙齿中,采用粘连性冠状神经根修复可以获得良好的长期结果,通过确保结构加固和日冕微渗漏预防。牙齿可能会严重失去冠状结构,可能需要放置桩/核心。在失败的情况下,这种牙髓修复组合确保了牙齿的存活,直到生长期结束,从而允许适当的假肢康复方法。
BACKGROUND: This study aimed to evaluate the long-term outcome of 16 permanent maxillary central incisors with nonvital pulps and open apices treated with apexification and corono-radicular adhesive restorations, within a follow-up span of 5 to 22 years.
METHODS: Fourteen patients providing a total of 16 teeth treated with mineral trioxide aggregate (n = 12), Biodentine (n = 3), or β-tricalcium phosphate (n = 1) apical barrier and corono-radicular restoration, with or without fiberglass post, were included. Clinical and radiographic criteria were defined for assessment at recall. Restoration and periapical tissue status evaluation were performed according to FDI World Dental Federation\'s esthetic, functional, and biological criteria and Ørstavik Periapical Index (PAI). Outcome was dichotomized as \"healed\" (PAI ≤ 2, asymptomatic with absence of signs of infection) or \"not healed\" (PAI ≥ 3, presence of clinical signs and/or symptoms).
RESULTS: Fourteen of 24 patients were available for the present study (recall rate = 58%). Within a follow-up of 5 to 22 years, 10 (62.5%) teeth were considered \"healed,\" fulfilling both strict clinical and radiographic success criteria. Only 1 tooth was missing due to root resorption and 1 patient was presenting with clinical signs and symptoms at recall, resulting in a survival rate of 93.8%.
CONCLUSIONS: Adhesive corono-radicular restoration in nonvital permanent immature teeth treated with apexification allows for favorable long-term outcomes, by ensuring structural reinforcement and coronal microleakage prevention. Teeth sustaining a substantial loss of coronal structure may require post/core placement. In the
case of failure, this endodontic-restorative combination ensured teeth survival until growth phase conclusion, thus allowing for proper prosthetic rehabilitation approaches.