【正文】
外力直接撞擊 ,咀嚼咬到沙石、碎骨等硬物。 be impacted by force,biting hard food. Etiology Clinic characteristics 按部位分 : 冠折 Crown fracture 根折 Root fracture 冠根聯(lián)合折 Crownroot fracture 按損傷和牙髓關(guān)系分 : 露髓 不露髓 冠折 crown fracture 前牙 : 橫折、斜折 Anterior tooth: horizontal or inclined 后牙 : 斜折、縱折 Posterior teeth:inclined or vertical 根折 root fracture 頸 1/根中 1/根尖 1/3 cervixthirds,middlethirds,apicalthirds 根折可有牙齒松動、叩痛、齦溝出血、粘膜觸痛等。 有的早期無明顯癥狀,數(shù)日后出現(xiàn)。 無根折外傷恒牙牙髓壞死率為 38%~ 59% 根折牙牙髓壞死率為 20%~ 24%,斷端間隙利于炎癥引流。 X片是診斷根折的重要依據(jù) Diagnosis can be carried out by radiographic examination 冠根折 crownroot fracture 以斜行多見, 牙髓常暴露。 The fracture will often be inclined with pulp exposure 缺損少牙本質(zhì)未暴露,磨光銳邊。 冠折 crown fracture Without dentin exposure,selective grinding of the incisal edge is sufficient. 牙本質(zhì)暴露敏感者,蓋髓樹脂修復(fù)。 Cover with Ca(OH)2 and posite resin restoration if dentin is expose and sensitive 牙髓暴露,牙根發(fā)育完成者行活髓摘除術(shù),牙根發(fā)育未完成者行活髓切斷術(shù)。 In case of a pulp exposure,pulpectomy is indicated if the root apical is developed,pulpotomy is sufficient if the root apical is developing. 根折 root fracture 根中 1/3折,根尖 1/3折 middlethirds,apicalthirds 用夾板固定三個月,如牙冠端有錯位,在固定前應(yīng)復(fù)位。 Reposition the coronal fragment and use splinting for 3 months 在治療后 12個月定期復(fù)查牙髓的活力狀況,一旦發(fā)現(xiàn)牙髓有炎癥或壞死趨勢,則應(yīng)作根管治療術(shù)。 Check for pulpal plications after 1 month,3 months