揭育培 林竺

[摘要]目的：探讨牙髓血管再生术治疗年轻恒牙牙髓坏死的临床疗效。方法：选取笔者医院收治的年轻恒牙牙髓坏死患者52例（共52颗患牙），并随机分为观察组和对照组，每组26例（26颗患牙）。观察组采用牙髓血管再生术治疗，对照组采用根尖诱导成形术治疗，术后定期随访18个月。随访结束后，比较两组治疗效果、牙髓活力测试结果及牙根发育情况，并观察不良反应发生情况。结果：随访结束后，观察组临床有效率为96.15%，高于对照组的73.08%（P<0.05）;观察组牙髓活力阳性率30.77%，高于对照组的0.00%;观察组牙根发育率65.38%，高于对照组的26.92%（P<0.05）。治疗过程中及随访期间，两组均未有治疗不良反应及材料宿主反应的发生。结论：牙髓血管再生术治疗年轻恒牙牙髓坏死，临床疗效显著优于根尖诱导成形术，可促进患者牙根继续发育，且安全性良好。

[关键词]年轻恒牙;牙髓坏死;牙髓血管再生术;根尖诱导成形术

[中图分类号]R783.4   [文献标志码]A   [文章编号]1008-6455（2019）02-0123-03

Abstract： Objective To explore the effect of pulp regeneration and revascularization in the treatment of pulpal necrosis of the immature permanent tooth. Methods  52 cases of patients （52 affected teeth） with pulpal necrosis of the immature permanent tooth in our hospital were selected and divided randomly into observation group and control group with 26 cases in each. The observation group was treated with pulp regeneration and revascularization， and the control group was treated with apical induction angioplasty and followed up for 18 months.The therapeutic effects of the 2 groups were compared， the dental pulp vitality test results and tooth root development were compared between the 2 groups， and the occurrence of adverse reactions were observed. Results  At the end of the follow-up， the effective rate， positive rate of dental pulp vitality and tooth root development rate in the observation group was 96.15%， 30.77%， 65.38%， which was obviously higher than that in the control group （73.08%， 0.00%， 26.92% ） （P<0.05 ）. During the course of treatment and follow-up period， no adverse events or material-host reaction events occurred in the 2 groups. Conclusion  Pulp regeneration and revascularization in the treatment of pulpal necrosis of the immature permanent tooth has better clinical efficacy than apical induction angioplasty， wihch can promote the continued development of the tooth root of patients， and it has good security.

Key words：immature permanent tooth;pulp necrosis;pulp regeneration and revascularization; apical induction angioplasty; curative efficacy

年輕恒牙通常是指恒牙牙根根尖孔未闭合之前的阶段，具有矿化度低、硬组织薄的特点，因此，可因外伤、龋病及发育异常造成牙髓感染、坏死、根尖周炎等情况发生，导致牙折的发生率升高[1]。目前，国内外临床上治疗年轻恒牙牙髓坏死常采用根尖诱导成形术，但患牙会出现短根、根管壁过薄及牙根停止发育等现象，长时间应用氢氧化钙进行诱导也会增加根折及二次感染的几率[2]。近年来，牙髓血管再生治疗法在临床有相关报道，可促进年轻恒牙牙髓坏死患者的牙根继续发育，且无需对根管进行机械性的预备[3]。本研究就牙髓血管再生术治疗年轻恒牙牙髓坏死患者的临床效果进行观察，现将结果报道如下。

1  资料和方法

1.1 一般资料：选取2014年8月-2016年6月笔者医院收治的年轻恒牙牙髓坏死患者52例（共52颗患牙），所有患者均经X线片及实验室检查确诊。……