- 期刊
Management of Immature Maxillary Anterior Teeth with Complicated Crown Fracture
上顎未成熟前牙之複雜性牙冠斷裂處置
摘要
Crown fracture of the anterior teeth is common in dental trauma of children and adolescents. Injuries of immature anterior teeth with pulp involvement could result in infection of the pulp. Under proper diagnosis, vital pulp therapy could preserve the remaining healthy pulp tissue and keep continuous root development. Reattachment of the fragments is an conservative and cost-effective method to restore the fracture tooth. This case report describes a 9-year-10-month-old boy with complicated crown fracture of both maxillary central incisors and left maxillary lateral incisor with incomplete root formation. The partial pulpotomy was performed with mineral trioxide aggregate (MTA) dressing, and reattachment of the fragments with composite resin. Two-year follow-up, the treated teeth showed normal function and esthetics, and the pulp response was normal. The treated teeth showed complete root formation and no root resorption or apical lesion was noted under the radiographic examination. Under careful diagnosis, evaluation and following the protocol of vital pulp therapy and fragment reattachment have shown satisfactory outcomes restoring good esthetics and function in the case of complicated crown fracture.
並列摘要
上顎前牙牙冠斷裂為常見的兒童及少年的牙齒外傷。對於未發育成熟的牙齒因外傷而導致牙髓暴露，若無給予適當的治療可能會造成牙髓感染，除影響牙根發育外，斷裂的前牙也會影響美觀及功能，經過適當的診斷，活髓治療可保存剩餘健康的牙髓組織，並維持牙根的發育。針對此種牙齒斷裂的處置，裂齒碎片再黏合（reattachment）的術式較為簡單、經濟且可達良好成效的治療方式。本報告為一個九歲十個月的男孩，因外傷造成牙根尚未發育完全的左上、右上正中恆門齒及左上恆側門齒複雜性牙冠斷裂，對患齒進行部分斷髓治療後，使用氧化礦化物混合物（MTA, mineral trioxide aggregate）覆蓋於斷髓處，再將裂齒碎片再重新黏合。術後兩年的回診追蹤，患齒的功能與美觀正常，也有的牙髓的反應。放射影像無根尖的發炎或牙根吸收的現象，且患齒的牙根也已發育成熟。經過適當的診斷與評估，以及確實執行裂齒碎片再黏合的術式，對於複雜性牙冠斷裂的牙齒，部分斷髓治療與裂齒碎片再黏合術式可使患齒恢復良好的美觀與功能。