Pulp revascularization of immature teeth with apical periodontitis: a clinical study

目的 评价牙髓血运重建术治疗年轻恒牙根尖周病变的临床效果,为临床治疗年轻恒牙根尖周病变提供新思路.方法 选择诊断为急性或慢性根尖周炎的年轻恒牙9颗,术前拍摄X线片,记录根尖周病变和牙根发育状况,进行牙髓血运重建术.术后对每颗患牙进行临床和X线片评价.结果 治疗后18 ～24个月,6颗患牙X线片显示根尖病变消失,牙根继续发育,表现为牙根延长、根管壁增厚和根尖闭合；1颗患牙根尖病变消失,但牙根发育不明显；2颗患牙治疗失败,改为进行根尖诱导成形术.结论 临床观察结果显示牙髓血运重建术治疗发生根尖周病变的年轻恒牙可行,部分病例可以获得牙根的继续发育；如果治疗失败,可以改行根尖诱导成形术.To evaluate the clinical effect of pulp revascularization procedure for immature teeth with apical periodontitis.Nine immature permanent teeth diagnosed with chronic or acute apical periodontitis were recruited. According to a standard pulp revascularization procedure, the canal was disinfected with copious irrigation and a combination of three antibiotics, followed by a blood clot created in the canal. Patients were recalled periodically after the treatment. Clinical and radiographic evidence of healing was evaluated.Eighteen to 24 months after treatment, 6 teeth showed complete resolution of the radiolucency and closure of the apex and thickening of the dentinal walls. One tooth showed healing of periodontal lesion, but the root mature was not observed. Two teeth had recurrent apical periodontitis and no evidence of healing. Apexification was performed later.Pulp revascularization could be an effective treatment for immature permanent teeth with apical periodontitis, and root elongation and narrowing canal space were observed in appropriate cases. If the treatment failed, traditional apexification could be started instead.PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)0281-854