110例儿童牙外伤临床特征及发生牙髓坏死的相关因素探讨

doi:10.19438/j.cjoms.2024.05.010

摘要/Abstract

摘要： 目的: 探讨儿童乳牙、恒牙的外伤特征及治疗后发生牙髓坏死的影响因素。方法: 选择2021年6月—2022年6月在绍兴市口腔医院门诊接受治疗的110例（169颗牙）牙外伤儿童,统计分析牙外伤的年龄和性别分布、恒牙及乳牙受伤构成、患牙牙位及数目。按照患儿是否发生牙髓坏死分为牙髓坏死组和牙髓存活组,比较2组患儿的基本特征,采用单因素及多因素模型分析影响牙外伤后发生牙髓坏死的危险因素。采用SPSS 21.0软件包对数据进行统计学分析。结果: 110例牙外伤患儿中,男57例,女53例。男性患儿牙外伤发生占比较高的年龄是5岁（21.05%）和6岁（19.30%）,女性占比较高的年龄是5岁（15.09%）,4岁组、6岁组和7岁组均为13.21%。110例牙外伤患儿共计损伤牙169颗,其中冠折102颗（60.36%）,脱出型67颗（39.64%）;恒牙损伤73例（66.36%）、乳牙损伤37例（33.64%）。牙位以中切牙为主（92颗,54.44%）。110例牙外伤患儿中,发生牙髓坏死37例（59颗患牙）,牙髓存活73例（110颗患牙）;牙髓坏死组和牙髓存活组的平均年龄、损伤牙类型、外伤类型、损伤牙位分布无显著差异（P>0.05）。牙髓坏死组中,男性患儿占比、冠折类型中Ⅲ~Ⅳ型占比、脱出类型中3级占比、就诊时间≥24 h占比、牙槽骨损伤占比均显著高于牙髓存活组患儿（P<0.05）。Logistic回归模型结果显示,男性患儿、冠折类型中Ⅲ~Ⅳ型、脱出类型中3级、合并牙槽骨损伤是牙外伤患儿治疗后发生牙髓坏死的独立危险因素（P<0.05）。结论: 儿童乳牙、恒牙外伤的好发年龄为5~6岁,且以恒牙及切牙损伤为主,男性患儿、冠折类型中Ⅲ~Ⅳ型、脱出类型中3级、合并牙槽骨损伤可增加患儿发生牙髓坏死的风险。

关键词: 儿童, 乳牙, 恒牙, 牙外伤, 牙髓坏死, 影响因素

Abstract: PURPOSE: To explore the traumatic characteristics of primary and permanent teeth in children and the influencing factors of pulp necrosis after treatment. METHODS: A total of 110 children with dental trauma(169 teeth involved) who received treatment at Dental Clinic, Shaoxing Stomatological Hospital from June 2021 to June 2022 were selected. The age, gender distribution, composition of permanent and deciduous teeth injuries, location and number of affected teeth were statistically analyzed. The children were divided into pulp necrosis group and pulp survival group according to whether pulp necrosis occurred. The basic characteristics of the two groups were compared, and the risk factors of pulp necrosis after dental trauma were analyzed by univariate and multivariate factor models. SPSS 21.0 software package was used for data analysis. RESULTS: Among the 110 children with dental trauma, there were 57 male and 53 female patients. The age group with the highest incidence of dental trauma in male patients was 5 years old (21.05%) and 6 years old (19.30%), while the age group with the highest incidence in female patients was 5 years old (15.09%). The 4-year-old group, 6-year-old group, and 7-year-old group all had a rate of 13.21%. A total of 169 teeth were injured in the 110 children with dental trauma, of which 102 teeth were fractured (60.36%) and 67 teeth were avulsed (39.64%). Among the injured teeth, 73 were permanent teeth (66.36%) and 37 were deciduous teeth (33.64%). The most common location of injured teeth was the central incisors (92 teeth, 54.44%). Among the 110 children with dental trauma, 37 had pulp necrosis (59 teeth), while 73 had pulp survival(110 teeth). There was no significant difference in the average age, type of injured teeth, type of trauma, and location of injured teeth between the pulp necrosis group and the pulp survival group(P>0.05). The proportion of male patients, the proportion of type Ⅲ-Ⅳ fractures, the proportion of grade 3 avulsion, the proportion of patients with a visit time of ≥24 hours, and the proportion of patients with bone injury were all significantly higher in the pulp necrosis group than in the pulp vitality group (P<0.05). The results of the logistic regression model showed that male children, type Ⅲ-Ⅳ of crown fracture, grade 3 of protrusion type, and combined alveolar bone injury were independent risk factors for dental pulp necrosis in children with dental trauma after treatment(P<0.05). CONCLUSIONS: The most common age of primary and permanent teeth trauma in children is 5-6 years old, with permanent and incisor injuries being the main cause. Male children, those with type Ⅲ-Ⅳ coronal fractures, those with grade 3 protrusions, and those with combined alveolar bone injuries can increase the risk of dental pulp necrosis.

Key words: Children, Deciduous teeth, Permanent teeth, Trauma, Pulp necrosis, Influence factor

中图分类号:

R788.4

刘佳乐, 蔡蕾, 杨钰云, 张燕飞. 110例儿童牙外伤临床特征及发生牙髓坏死的相关因素探讨[J]. 中国口腔颌面外科杂志, 2024, 22(5): 468-472.

LIU Jia-le, CAI Lei, YANG Yu-yun, ZHANG Yan-fei. Clinical characteristics and related factors of pulp necrosis in 110 children with primary and permanent teeth injuries[J]. China J Oral Maxillofac Surg, 2024, 22(5): 468-472.

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