恒牙全脱出再植后进行性根吸收的管理

doi:10.13591/j.cnki.kqyx.2025.10.013

摘要/Abstract

摘要：

恒牙全脱出是最严重的一种牙齿损伤,对生长发育期的青少年,牙再植术是治疗恒牙全脱出的最佳方案。由于牙周组织的严重损伤及牙周膜细胞的死亡,术后容易继发进行性根吸收。临床上进行性根吸收的管理是牙再植后的一大挑战,控制牙根吸收进展、延长牙齿保留时间具有重要意义。文章对近年来全脱出再植后进行性替代性吸收及炎性吸收的研究及治疗作一综述。

关键词: 全脱出, 再植术, 替代性吸收, 炎性吸收

Abstract:

Avulsion of permanent teeth is the most severe type of tooth injury. Replantation has been widely recognized as the optimal method for managing avulsed permanent teeth in teenagers. Due to significant damage to periodontal tissue and death of periodontal membrane cells, secondary progressive root resorption often occurs after tooth replantation. Managing progressive root resorption clinically poses a major challenge following tooth replantation. It is crucial to control root resorption and prolong tooth retention time. This article reviews recent research and treatment on progressive replacement absorption and inflammatory absorption after replantation.

Key words: avulsion, replantation, replacement resorption, inflammatory resorption

中图分类号:

R782.12

彭思慧, 罗攀, 罗媲, 江洁. 恒牙全脱出再植后进行性根吸收的管理[J]. 口腔医学, 2025, 45(10): 795-800.

PENG Sihui, LUO Pan, LUO Pi, JIANG Jie. Management of progressive root resorption in replantation to avulsion[J]. Stomatology, 2025, 45(10): 795-800.

参考文献 58

[1]	葛立宏. 儿童口腔医学[M]. 5版. 北京: 人民卫生出版社, 2020: 147-150.
[2]	Demir P, Guler C, Kizilci E, et al. Survival of avulsed permanent incisors in children following delayed replantation[J]. Niger J Clin Pract, 2020, 23(5): 631-637. doi: 10.4103/njcp.njcp_496_19 pmid: 32367869
[3]	Lauridsen E, Andreasen JO, Bouaziz O, et al. Risk of ankylosis of 400 avulsed and replanted human teeth in relation to length of dry storage: A re-evaluation of a long-term clinical study[J]. Dent Traumatol, 2020, 36(2): 108-116. doi: 10.1111/edt.12520 pmid: 31631495
[4]	吕丽华, 苏吉梅. 年轻恒牙外伤性牙齿固连研究进展[J]. 中国实用口腔科杂志, 2020, 13(9): 559-563. doi: 10.19538/j.kq.2020.09.008
[5]	Bastos JV, Queiroz VHF, FelÍcio DBA, et al. Imaging diagnosis of external root resorption in replanted permanent teeth[J]. Braz Oral Res, 2020, 34: e067.
[6]	Gul A, Lauridsen E, Gerds TA, et al. Risk of ankylosis of avulsed teeth immediately replanted or stored under favorable storage conditions before replantation: A long-term clinical study[J]. Dent Traumatol, 2024, 40(2): 137-143.
[7]	Fouad AF, Abbott PV, Tsilingaridis G, et al. International association of dental traumatology guidelines for the management of traumatic dental injuries: 2. avulsion of permanent teeth[J]. Dent Traumatol, 2020, 36(4): 331-342. doi: 10.1111/edt.12573 pmid: 32460393
[8]	Adnan S, Lone MM, Khan FR, et al. Which is the most recommended medium for the storage and transport of avulsed teeth?A systematic review[J]. Dent Traumatol, 2018, 34(2): 59-70.
[9]	Albertsson J, Lauridsen E, Andreasen JO, et al. The risks of ankylosis of 89 avulsed human teeth stored in saliva prior to replantation-a re-evaluation of a long-term clinical study[J]. Dent Traumatol, 2021, 37(4): 537-545. doi: 10.1111/edt.12659 pmid: 33527633
[10]	Koca H, Topaloglu-Ak A, Sütekin E, et al. Delayed replantation of an avulsed tooth after 5 hours of storage in saliva: A case report[J]. Dent Traumatol, 2010, 26(4): 370-373. doi: 10.1111/j.1600-9657.2010.00910.x pmid: 20662889
[11]	Sonoda CK, Poi WR, Panzarini SR, et al. Tooth replantation after keeping the avulsed tooth in oral environment: Case report of a 3-year follow-up[J]. Dent Traumatol, 2008, 24(3): 373-376. doi: 10.1111/j.1600-9657.2007.00522.x pmid: 18489489
[12]	Wang GY, Wang C, Qin M. A retrospective study of survival of 196 replanted permanent teeth in children[J]. Dent Traumatol, 2019, 35(4/5): 251-258.
[13]	盛恺, 汪俊. 儿童全脱出牙外伤的序列治疗[J]. 中国实用口腔科杂志, 2022, 15(4): 390-394.
[14]	Kahler B, Heithersay GS. An evidence-based appraisal of splinting luxated, avulsed and root-fractured teeth[J]. Dent Traumatol, 2008, 24(1): 2-10. doi: 10.1111/j.1600-9657.2006.00480.x pmid: 18173657
[15]	Hinckfuss SE, Messer LB. Splinting duration and periodontal outcomes for replanted avulsed teeth: A systematic review[J]. Dent Traumatol, 2009, 25(2): 150-157. doi: 10.1111/j.1600-9657.2008.00761.x pmid: 19290892
[16]	Hadziabdic N. The basics of splinting in dentoalveolar traumatology[M]// Hadziabdic N Maxillofacial Surgery and Craniofacial Deformity-Practices and Updates. London: Intech Open, 2020.
[17]	de Souza FI, Poi WR, da Silva VF, et al. Stress distribution in delayed replanted teeth splinted with different orthodontic wires: A three-dimensional finite element analysis[J]. Dent Traumatol, 2015, 31(3): 190-195. doi: 10.1111/edt.12159 pmid: 25604805
[18]	Andersson L, Lindskog S, Blomlof L, et al. Effect of masticatory stimulation on dentoalveolar ankylosis after experimental tooth replantation[J]. Endod Dent Traumatol, 1985, 1(1): 13-16. pmid: 3858091
[19]	Mine K, Kanno Z, Muramoto T, et al. Occlusal forces promote periodontal healing of transplanted teeth and prevent dentoalveolar ankylosis: An experimental study in rats[J]. Angle Orthod, 2005, 75(4): 637-644. pmid: 16097234
[20]	Sobczak-Zagalska H, Emerich K. Assessment of a power chain as a new dental trauma splint and its comparison with two commonly used splinting materials[J]. Appl Sci, 2020, 10(23): 8398.
[21]	Sae-Lim V, Wang CY, Choi GW, et al. The effect of systemic tetracycline on resorption of dried replanted dogs’ teeth[J]. Endod Dent Traumatol, 1998, 14(3): 127-132. pmid: 9863422
[22]	Andreasen JO, Storgård jensen S, Sae-lim V. The role of antibiotics in preventing healing complications after traumatic dental injuries: A literature review[J]. Endod Top, 2006, 14(1): 80-92.
[23]	Abbott PV, Lin S. Tooth resorption-part 2: A clinical classification[J]. Dent Traumatol, 2022, 38(4): 267-285.
[24]	Peric T, Markovic D, Petrovic B. Mineral trioxide aggregate for the treatment of external root resorption in an avulsed immature tooth-ten years of follow-up[J]. Srp Arh Celok Lek, 2020, 148(3/4): 231-235.
[25]	Yoon H, Song MJ. Long-term retention of avulsed maxillary incisors with replacement root resorption: A 9-year follow-up[J]. Case Rep Dent, 2021, 2021: 8872859.
[26]	di Giorgio G, Salucci A, Sfasciotti GL, et al. External root resorption management of an avulsed and reimplanted central incisor: A case report[J]. Dent J, 2021, 9(6): 72.
[27]	Terranova VP, Franzetti LC, Hic S, et al. A biochemical approach to periodontal regeneration: Tetracycline treatment of dentin promotes fibroblast adhesion and growth[J]. J Periodontal Res, 1986, 21(4): 330-337. pmid: 2942661
[28]	刘佳佳, 杜样, 邸天凯, 等. 全脱出恒牙再植预后临床研究进展[J]. 中国实用口腔科杂志, 2021, 14(2): 225-228. doi: 10.19538/j.kq.2021.02.020
[29]	Segura-Egea JJ, Gould K, Hakan Şen B, et al. Antibiotics in endodontics: A review[J]. Int Endod J, 2017, 50(12): 1169-1184. doi: 10.1111/iej.12741 pmid: 28005295
[30]	Gulinelli JL, Panzarini SR, Fattah CM, et al. Effect of root surface treatment with Propolis and fluoride in delayed tooth replantation in rats[J]. Dent Traumatol, 2008, 24(6): 651-657. doi: 10.1111/j.1600-9657.2008.00667.x pmid: 18721196
[31]	Mohammadi Z, Cehreli ZC, Shalavi S, et al. Management of root resorption using chemical agents: A review[J]. Iran Endod J, 2016, 11(1): 1-7.
[32]	Panzarini SR, Gulinelli JL, Poi WR, et al. Treatment of root surface in delayed tooth replantation: A review of literature[J]. Dent Traumatol, 2008, 24(3): 277-282. doi: 10.1111/j.1600-9657.2008.00555.x pmid: 18410388
[33]	Abbott PV. Prevention and management of external inflammatory resorption following trauma to teeth[J]. Aust Dent J, 2016, 61(Suppl 1): 82-94.
[34]	Cvek M, Abbott PV, Bakland LK, et al. Management of trauma related pulp disease and tooth resorption[M]. // Andreasen JO, Andersson FM, Andersson L. Textbook and color atlas of traumatic injuries to the teeth. 5th ed. Copenhagen: Wiley, 2019: 648-717.
[35]	Patel S, Saberi N, Pimental T, et al. Present status and future directions: Root resorption[J]. Int Endod J, 2022, 55(Suppl 4): 892-921.
[36]	Rosenberg B, Murray PE, Namerow K. The effect of calcium hydroxide root filling on dentin fracture strength[J]. Dent Traumatol, 2007, 23(1): 26-29. pmid: 17227377
[37]	Athanassiadis B, Abbott P, George N, et al. Anstudy of the antimicrobial activity of some endodontic medicaments against Enteroccus faecalis biofilms[J]. Aust Dent J, 2010, 55(2): 150-155. doi: 10.1111/j.1834-7819.2010.01222.x pmid: 20604756
[38]	Day PF, Gregg TA, Ashley P, et al. Periodontal healing following avulsion and replantation of teeth: A multi-centre randomized controlled trial to compare two root canal medicaments[J]. Dent Traumatol, 2012, 28(1): 55-64. doi: 10.1111/j.1600-9657.2011.01053.x pmid: 21988960
[39]	Torabinejad M, Parirokh M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: An updated overview-partⅡ: Other clinical applications and complications[J]. Int Endod J, 2018, 51(3): 284-317. doi: 10.1111/iej.12843 pmid: 28846134
[40]	Sadeghi SM, Moradi S, Soltani S. Management of inflammatory root resorption of maxillary central incisors following traumatic avulsion[J]. Case Rep Dent, 2021, 2021: 6309711.
[41]	Marão HF, Panzarini SR, Aranega AM, et al. Periapical tissue reactions to calcium hydroxide and MTA after external root resorption as a sequela of delayed tooth replantation[J]. Dent Traumatol, 2012, 28(4): 306-313. doi: 10.1111/j.1600-9657.2011.01090.x pmid: 22151580
[42]	Muraleedhar AV, Satish SV, Uthappa R, et al. Comparative evaluation of the fracture resistance of roots after the application of three different root canal sealers[J]. Saudi J Oral Sci, 2022, 9(3): 175-179.
[43]	Zachrisson BU. Planning esthetic treatment after avulsion of maxillary incisors[J]. J Am Dent Assoc, 2008, 139(11): 1484-1490. pmid: 18978386
[44]	Tsukiboshi M, Yamauchi N, Tsukiboshi Y. Long-term outcomes of autotransplantation of teeth: A case series[J]. Dent Traumatol, 2019, 35(6): 358-367. doi: 10.1111/edt.12495 pmid: 31127697
[45]	Akhlef Y, Schwartz O, Andreasen JO, et al. Autotransplantation of teeth to the anterior maxilla: A systematic review of survival and success, aesthetic presentation and patient-reported outcome[J]. Dent Traumatol, 2018, 34(1): 20-27. doi: 10.1111/edt.12379 pmid: 28990720
[46]	Plotino G, Abella Sans F, Duggal MS, et al. Clinical procedures and outcome of surgical extrusion, intentional replantation and tooth autotransplantation-A narrative review[J]. Int Endod J, 2020, 53(12): 1636-1652.
[47]	Rohof ECM, Kerdijk W, Jansma J, et al. Autotransplantation of teeth with incomplete root formation: A systematic review and meta-analysis[J]. Clin Oral Investig, 2018, 22(4): 1613-1624.
[48]	Królik A, Kalinowska J, Racka-Pilszak B. The use of decoronation in cases of post-traumatic replacement resorption: A literature review[J]. For, 2020, 15(2): 159-169.
[49]	Malmgren B, Tsilingaridis G, Malmgren O. Long-term follow up of 103 ankylosed permanent incisors surgically treated with decoronation: A retrospective cohort study[J]. Dent Traumatol, 2015, 31(3): 184-189. doi: 10.1111/edt.12166 pmid: 25808297
[50]	Berlin-Broner Y, Al Bawaliz L, Levin L. Implications of post-traumatic treatment of immature maxillary incisors[J]. Int Dent J, 2023, 73(3): 337-345. doi: 10.1016/j.identj.2023.01.005 pmid: 36804746
[51]	Malmgren B, Malmgren O. Rate of infraposition of reimplanted ankylosed incisors related to age and growth in children and adolescents[J]. Dent Traumatol, 2002, 18(1): 28-36. pmid: 11841463
[52]	Malmgren B, Cvek M, Lundberg M, et al. Surgical treatment of ankylosed and infrapositioned reimplanted incisors in adolescents[J]. Scand J Dent Res, 1984, 92(5): 391-399. pmid: 6593804
[53]	Consolaro A, Ribeiro Júnior PD, Cardoso MA, et al. Decoronation followed by dental implants placement: Fundamentals, applications and explanations[J]. Dental Press J Orthod, 2018, 23(1): 24-36. doi: S2176-94512018000100024 pmid: 29791693
[54]	Mohadeb JV, Somar M, He H. Effectiveness of decoronation technique in the treatment of ankylosis: A systematic review[J]. Dent Traumatol, 2016, 32(4): 255-263. doi: 10.1111/edt.12247 pmid: 26663218
[55]	Tsukiboshi M, Tsukiboshi T. Bone morphology after delayed tooth replantation-case series[J]. Dent Traumatol, 2014, 30(6): 477-483. doi: 10.1111/edt.12111 pmid: 24720285
[56]	Walia T, Chandwani N. Long-term management of an ankylosed young permanent incisor replanted within 2 h of avulsion: A case report with a 10-year follow-up[J]. J Indian Soc Pedod Prev Dent, 2019, 37(1): 99-106. doi: 10.4103/JISPPD.JISPPD_106_18 pmid: 30804315
[57]	Han JE, Kim GM, Kim HJ, et al. Long-term prognosis after decoronation of avulsed teeth with replacement resorption: A report of three cases[J]. J Clin Pediatr Dent, 2024, 48(1): 204-211.
[58]	Ionta FQ, Gonçalves PSP, Honório HM, et al. Delayed tooth reimplantation with 4-year follow-up: The management of ankylosis during facial growth[J]. Gen Dent, 2018, 66(3): 53-57. pmid: 29714701