口腔医学 ›› 2025, Vol. 45 ›› Issue (4): 275-280.doi: 10.13591/j.cnki.kqyx.2025.04.007

• 基础与临床研究 • 上一篇    下一篇

带牵引设计的铸造桩核冠向牵引龈下牙折上前牙的临床效果

方铁钧1(), 梁惠敏2, 黄敏莉2   

  1. 1.广东省中山市口腔医院种植修复中心,广东中山(528400)
    2.广东省中山市口腔医院正畸科,广东中山(528400)
  • 收稿日期:2024-06-05 出版日期:2025-04-28 发布日期:2025-04-25
  • 通讯作者: 方铁钧, E-mail:fangtj@163.com

Clinical application effects of cast post and cores with traction design in coronal extrusion of upper anterior teeth with subgingival fracture

FANG Tiejun1(), LIANG Huimin2, HUANG Minli2   

  1. Department of Implant-Prosthodontics Center, Hospital of Stomatology, Zhongshan City, Zhongshan 528400, China
  • Received:2024-06-05 Online:2025-04-28 Published:2025-04-25

摘要:

目的 评价带牵引设计的铸造桩核冠向牵引龈下牙折上前牙的临床效果。方法 选择25颗外伤折断至龈下的上前牙,完成根管治疗后进行带牵引设计的铸造桩核及树脂冠修复,正畸牵引至预定位置并保持,调整龈缘位置至稳定后完成冠修复。分析患牙牵出长度与牵引时间及牙根冠方移动量的相关性,统计牵引完成后患者冠根比值及患牙骨内桩长度与骨内根长度的比值,3、6、12个月复诊评价修复的临床效果。结果 25颗患牙有1颗在牵引第6周时出现牙根吸收,剩余24颗患牙全部牵引至目标位置及最终完成修复。统计分析显示牵引时间(y1)、牙龈冠方移动量(y2)与牵引长度(x)存在正相关性。牵引完成后患牙冠根比与对侧同名牙相比差异无统计学意义(P>0.05),患牙骨内桩长度与骨内根长度比值大于1/2。3、6、12个月复查患牙修复临床效果稳定。结论 带牵引设计的铸造桩核在龈下牙折的上前牙保存中具有良好的应用效果。

关键词: 前牙, 正畸牵引, 龈下牙折, 生物学宽度

Abstract:

Objective To evaluate the clinical effects of cast post and cores with traction design in coronal extrusion of upper anterior teeth with subgingival fracture. Methods Twenty-five upper anterior teeth with subgingival fracture were treated by root canal therapy, then cast post and cores with traction design and composite resin crown restorations were made for orthodontic extrusion. Position retention and gingival margin modification were performed before crown restoration of these teeth. The correlation between extrusion length and extrusion time was evaluated, as well as the correlation between extrusion length and migration distance in coronal direction about the gingival margin. Crown-root ratio and post-root ratio below the alveolar crest was evaluated after the crown restorations were finished. Evaluation of restoration effects was carried out in 3, 6, 12 months follow-up period. Results Root resorption began to appear on one tooth at six weeks; the remaining 24 teeth were migrated to target position and prosthesis were finished. There was a positive correlation between the extrusion length (x) and extrusion time (y1), also between the extrusion length (x) and migration distance in coronal direction about the gingival margin (y2) by statistical analysis. There was no significant difference (P>0.05) between the extrusion teeth and compared teeth on crown-root ratio. More than 1/2 of the ratio between the length of post to the length of root below the alveolar crest. The prognostic stability was satisfied in 3, 6, 12 months follow-up period. Conclusion There are satisfactory clinical application effects of cast post and cores with traction design in coronal extrusion of upper anterior teeth with subgingival fracture.

Key words: anterior tooth, orthodontic extrusion, subgingival tooth fracture, biological width

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