- 期刊
Decoronation as a Solution for Ankylosed Teeth after Trauma Injury: A Case Report
牙冠祛除術用於外傷後牙齒黏連之處理
摘要
在兒童或青少年時期發生牙齒外傷後併發之牙齒黏連易導致低位咬合及局部齒槽骨發育遲滯。如果受侵犯的牙齒在青春期之前提早被拔除，亦會造成局部齒槽骨大量流失，不利於日後贗復或植牙。牙冠祛除術是將患齒之牙冠移除，僅餘留牙根埋沒齒槽骨中逐漸被吸收。此手術的目的為維持局部齒槽骨的高度及寬度以利贗復。本篇文章報告兩名上顎前牙因外傷脫落並再植回之案例，再植回後數月間觀察到牙齒黏連之症狀及患齒低位咬合之情形。因此對於此兩案例進行牙冠祛除術。之後三年觀察期間，埋沒齒槽骨中之牙根逐漸被吸收，並且局部齒槽骨仍保持良好之高度及寬度。牙冠祛除術已被國際牙齒外傷協會之治療指引列為處理牙齒外傷所導致之牙齒黏連的標準步驟，值得臨床兒童牙科醫師列入標準外傷治療流程之一。
並列摘要
Ankylosis of traumatic tooth in children and adolescents can result in infraocclusion of the affected teeth and disturb normal alveolar growth. If the ankylosed tooth is extracted before growth spurt, significant bony defect will occur in both vertical and bucco-palatal dimensions. Decoronation involves removing the crown portion of the ankylosed tooth, leaving the root submerged and gradually replaced by bone. The goal is to maintain adequate alveolar bone volume and vertical bone height facilitating final prosthesis. We reported two cases of upper anterior teeth replantation after avulsion. Signs of tooth ankylosis and significant infraocclusion were observed several months later, therefore, decoronation procedure was performed. During the 3-year follow-up period after decoronation, gradual resorption of submerged roots, yet well-preserved vertical and horizontal bone volumes were observed. Per IADT (International Association of Dental Traumatology) guidelines, decoronation is the recommended procedure for the preservation of the contour of the alveolar ridge in post-traumatic ankylosis and infraocclusion. Pediatric dentist should consider this as a part of standard protocol for traumatic injury management.