咬合創傷造成之牙周組織傷害

臨床上咬合應力造成牙周組織傷害的案例在臺灣相當常見，包括咬合創傷、牙根斷裂及牙骨質撕裂等，都可能造成可逆或不可逆的牙周損傷。咬合創傷分為初級和次級，常與不適當的贗復體或填補物、咬合異常功能有關。牙根斷裂則與嚴重創傷、咬食硬物、根管治療等相關。垂直牙根斷裂主要發生在小臼齒及第一大臼齒。牙骨質撕裂創傷是沿著牙根表面或牙骨質牙本質交界面，主要影響單根牙或門牙。垂直牙根斷裂與牙骨質撕裂在臺灣較為常見，可能與習慣性咬硬食物有關。本文旨在回顧國內外之文獻，歸納臨床三種臺灣常見之損傷性咬合造成的牙周組織傷害及併發症，以期幫助臨床醫師更了解其症狀及發生機制，也有利於及早警覺、診斷及介入治療，並進一步預防其再度發生。

關鍵字

咬合創傷；牙根斷裂；牙骨質撕裂

並列摘要

Occlusal trauma may cause injury to the periodontium, which may include trauma from occlusion, the presence of root fractures and the presence of cemental tears. Trauma from occlusion can be divided into two categories. These are, firstly, primary trauma from the occlusion including alternations to the occlusal force resulting in periodontal bone destruction and, secondly, secondary trauma from occlusion, which includes situations where the resistance of the periodontium to the occlusal force is reduced due to destruction of periodontal tissue and the presence of less bone support. Root fractures may include horizontal, oblique and vertical root fractures. Horizontal and oblique root fracture often result from severe traumatic injury. Vertical root fractures usually occurs on buccal and lingual sides and are related to habitual hard food chewing, attrition and lateral condensation force after root canal treatment. Cemental tears are mostly seen in teeth with a single root, especially the incisors and premolars. In addition to trauma from occlusion, vertical root fracture and cemental tears are also very common in Taiwan and seem to be related to the habitual chewing of hard food. A review of recent literature is presented. A better understanding of the signs, symptoms and related pathological mechanisms associated with these problems is especially important to their early diagnosis, treatment and future prevention.

並列關鍵字

occlusal trauma ； root fracture ； cemental tear

國際替代計量

咬合創傷造成之牙周組織傷害

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