牙吸收诱发因素与临床诊治策略

doi:10.13591/j.cnki.kqyx.2023.04.001

口腔医学 ›› 2023, Vol. 43 ›› Issue (4): 289-293.doi: 10.13591/j.cnki.kqyx.2023.04.001

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牙吸收诱发因素与临床诊治策略

李雪滢¹,邹晓英^1,²(),岳林¹()

1.北京大学口腔医学院·口腔医院牙体牙髓科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,北京(100081)
2.北京大学医院口腔中心,北京(100871)

修回日期:2022-11-14 出版日期:2023-04-28 发布日期:2023-05-08
通讯作者: 邹晓英,岳林 E-mail:zouxiaoying1125@pku.edu.cn;kqlinyue@bjmu.edu.cn
作者简介:专家介绍:邹晓英,北京大学医学博士,北京大学医院口腔中心副主任医师;中华口腔医学会牙体牙髓病学专业委员会委员;曾赴美国波士顿大学进行博士后工作。参编北京大学长学制教材《牙体牙髓病学》(第3版)、《牙体牙髓科临床规范诊疗工作手册》等多部著作,副主译《显微外科牙髓病学》。主要研究方向为根管内感染控制和牙髓再生。|专家介绍:岳林, 北京大学医学博士;北京大学口腔医学院教授、主任医师,博士研究生导师;中华口腔医学会副会长兼秘书长、常务理事,牙体牙髓病学专业委员会候任主任委员;中华预防医学会健康传播分会常委;北京市口腔医学会牙体牙髓病学专业委员会前任主任委员;国家执业医师资格考试命审题专家委员会主任委员;国家口腔医疗质控中心专家委员会副主任委员;北京市口腔医疗质量控制与管理委员会委员;《中华口腔医学杂志》等多种核心期刊编委和审稿人。主编北京大学长学制教材《牙体牙髓病学》(第2版、第3版),《临床龋病学》(第3版),主编国家医学考试中心唯一推荐《口腔执业医师资格考试医学综合指导用书》和《口腔执业医师资格考试实践技能指导用书》等著作,主译《牙髓外科实用教程》,副主编全国统编教材《牙体牙髓病学》第5版,参编第1~4版和研究生统编教材《龋病和牙体修复学》。
基金资助:
国家自然科学基金重大项目(81991501)

Predisposing factors, clinical diagnosis and treatment strategy of tooth resorption

LI Xueying¹,ZOU Xiaoying^1,²(),YUE Lin¹()

Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China

Revised:2022-11-14 Online:2023-04-28 Published:2023-05-08
Contact: ZOU Xiaoying,YUE Lin E-mail:zouxiaoying1125@pku.edu.cn;kqlinyue@bjmu.edu.cn

摘要/Abstract

摘要：

牙吸收是指包括牙根外吸收和牙内吸收在内的一类特发性牙齿疾病。其诱发因素复杂多样,至今未得到完善解释。在疾病早期,牙吸收常缺乏特征性临床表现,往往在引起牙髓症状后才被发现,这为疾病的早期诊断、干预带来困难。依据病变累及范围存在多种治疗方式,近年临床医师也在不断尝试创新的治疗方法,但缺乏系统性归纳整理。该文将从牙吸收的诱发因素、临床诊断、治疗等方面作一综述。

关键词: 牙吸收, 根吸收, 诱发因素, 诊断, 治疗

Abstract:

Tooth resorption is an idiopathic dental disease that can be further classified as external root resorption and internal tooth resorption. The predisposing factors are diverse and have not been well explained to date. In the early stages of tooth resorption, there are no characteristic clinical manifestations. As a result, tooth resorption is often detected only after it has caused pulpal symptoms, which makes early diagnosis and intervention difficult. A variety of treatment strategies exist depending on the extent of lesion involvement, and clinicians have been attempting with innovative treatment approaches in recent years, but there is a lack of systematic categorization. This review will focus on the predisposing factors, clinical diagnosis and treatment strategy of tooth resorption.

Key words: tooth resorption, root resorption, predisposing factor, diagnosis, treatment

中图分类号:

R781.3

李雪滢,邹晓英,岳林. 牙吸收诱发因素与临床诊治策略[J]. 口腔医学, 2023, 43(4): 289-293.

LI Xueying,ZOU Xiaoying,YUE Lin. Predisposing factors, clinical diagnosis and treatment strategy of tooth resorption[J]. Stomatology, 2023, 43(4): 289-293.

图/表 1

参考文献 39

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类型	牙根外吸收				牙内吸收
类型	表面性	炎症性	替代性	颈部	表面性	炎症性	替代性
临床症状及体征	无明显异常	牙冠颜色改变,动度增加,牙髓炎/根尖周炎症状	动度消失,叩诊金属音	牙颈部呈粉红色,探诊易出血,牙髓炎/根尖周炎症	无明显异常	状冠部透粉,牙髓炎/根尖周炎症状	无明显异常,或表现为牙髓炎/根尖周炎症状
牙髓活力	正常	异常	正常/异常	正常/异常	正常	异常	异常
影像学表现	不易分辨,牙根表面细小不规则影像,局部牙周膜增宽	牙根表面碟形凹陷,牙根变短,骨硬板影像消失	牙周膜、骨硬板影像消失,牙根表面不规则,骨组织直接接触牙根表面	颈部不规则透射影,可随投照角度改变发生位置变化,根管影像连续	不易分辨	髓腔内圆形/椭圆形透射影,对称或偏心分布,边缘光滑,不随投照角度改变发生位置变化	根管内非对称不规则增大影像,内部密度高低混杂,根管壁影像模糊

牙吸收诱发因素与临床诊治策略

Predisposing factors, clinical diagnosis and treatment strategy of tooth resorption

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