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Вестник Северо-Восточного федерального университета имени М К Аммосова Серия "Медицинские науки最新文献

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ON THE TOPIC OF ADVISABILITY OF ENDODONTIC TREATMENT OF RETAINED (PERSISTENT) PRIMARY TEETH 关于对滞留(顽固)乳牙进行牙髓治疗的可取性这一主题
V. Galonsky, E. Surdo, N. Tarasova, T. B. Zhuravleva
Treatment of complicated caries in children and adolescents has a number of features, which is determined by age-related anatomy and the limited functioning time of temporary teeth, as well as the timing of their root resorption. Today, the treatment of pulpitis of preserved temporary (persistent) teeth is of particular clinical interest. Persistent (delayed) teeth are temporary (baby) teeth that are preserved in the dentition after the physiological time of their replacement and are capable of functioning for 10 years or more. In most cases, the presence of retained temporary teeth is due to congenital edentia of permanent teeth, retention or death of their rudiments. There is no data in the literature on the features of the anatomical structure of persistent teeth and recommendations for their endodontic treatment. At the same time, in the treatment of this pathology, the methods of pulpotomy (devital amputation, impregnation method) and pulpectomy (pulp extirpation, vital method) are widely used, followed by obturation of the root canals with resorbable filling materials. Taking into account the above, we conducted a retrospective analysis of 192 orthopantomograms of patients with congenital permanent adentia and the presence of 289 persistent teeth. The anatomical features of the structure of the root canals of persistent teeth have been determined. The results of treatment of 44 preserved temporary teeth with chronic fibrous pulpitis in 27 patients of childhood and adolescence using the method of vital extirpation followed by restoration of the crown parts of the teeth using therapeutic and orthopedic methods are presented. Long-term treatment results up to 60 months were assessed. Meanwhile, the results obtained indicated the absence of signs of root resorption in persistent teeth over a long period of time from the period of their physiological change, as well as the features of the anatomical structure of root canals, similar to that of permanent teeth, and allowing endodontic treatment of preserved teeth using classical for permanent teeth pulpectomy method. The results of clinical observation and X-ray examination in the long term after treatment allow us to conclude that the approach used is highly effective, which reduced the risk of periapical complications and created conditions for the longterm functioning of persistent teeth.
儿童和青少年复杂龋齿的治疗有很多特点,这是由与年龄相关的解剖结构、临时牙的有限功能时间以及牙根吸收的时间决定的。如今,治疗保留的临时牙(恒牙)的牙髓炎是临床上特别关注的问题。暂存(延迟)牙是指在生理替换期结束后仍保留在牙列中的临时(乳)牙,其功能可维持 10 年或更长时间。在大多数情况下,暂留牙的存在是由于先天性恒牙缺失、恒牙基牙滞留或死亡造成的。文献中没有关于滞留牙解剖结构特点的数据,也没有关于牙髓治疗的建议。同时,在治疗这种病症时,牙髓切断术(牙髓切断、浸渍法)和牙髓切除术(牙髓切除、活力法)被广泛使用,然后用可吸收的填充材料对根管进行封堵。考虑到上述情况,我们对先天性恒牙缺失患者的 192 张正畸照片和 289 颗恒牙进行了回顾性分析。我们确定了恒牙根管结构的解剖学特征。本文介绍了对 27 名儿童和青少年患者的 44 颗患有慢性纤维性牙髓炎的临时牙进行治疗的结果,治疗方法是先进行活体拔除,然后使用治疗和矫形方法对牙冠部分进行修复。评估了长达 60 个月的长期治疗结果。同时,所获得的结果表明,持久性牙齿在其生理变化期后的很长一段时间内都没有牙根吸收的迹象,而且根管的解剖结构特征与恒牙相似,因此可以使用经典的恒牙牙髓切除法对保留的牙齿进行牙髓治疗。根据治疗后长期临床观察和 X 射线检查的结果,我们可以得出结论,所采用的方法非常有效,降低了根尖周并发症的风险,为恒牙的长期功能创造了条件。
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Вестник Северо-Восточного федерального университета имени М К Аммосова Серия "Медицинские науки
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