国际口腔医学杂志

国际口腔医学杂志 ›› 2025, Vol. 52 ›› Issue (5): 586-593.doi: 10.7518/gjkq.2025088

• 牙体牙髓专栏 • 上一篇    下一篇

牙髓组织应对牙外伤的生物学反应及相关临床诊疗策略

蒋小菊(),陈婧,苏勤()   

  1. 口腔疾病防治全国重点实验室 国家口腔医学中心 国家口腔疾病临床医学研究中心四川大学华西口腔医院牙体牙髓病科 成都 610041
  • 收稿日期:2024-08-05 修回日期:2024-11-23 出版日期:2025-09-01 发布日期:2025-08-27
  • 通讯作者: 苏勤
  • 作者简介:蒋小菊，学士，Email：1962698037@qq.com

Dental trauma: biological responses of pulp tissue, diagnosis, and treatment strategies

Xiaoju Jiang(),Jing Chen,Qin Su()   

  1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2024-08-05 Revised:2024-11-23 Online:2025-09-01 Published:2025-08-27
  • Contact: Qin Su

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摘要：

牙外伤在口腔临床治疗中极为普遍，不同类型和程度的牙外伤能触发牙髓组织的一系列生物学反应。有效评估牙髓状况并采取适宜的治疗措施，对于预防牙髓并发症，促进年轻恒牙牙根持续生长，以及最大限度地保留天然牙齿至关重要。本综述综合探讨了牙外伤引发的牙髓生物学变化，总结了牙髓状态的评估技术以及相应的治疗策略，以期为口腔临床医生进行牙外伤规范化诊疗提供依据。

关键词: 牙外伤, 牙髓组织, 牙髓治疗, 牙髓疾病

Abstract:

Traumatic dental injuries are a common clinical occurrence and encompass a spectrum of types and severities, which can elicit biological responses within the dental pulp. The accurate assessment of pulpal status, alongside timely and appropriate therapeutic interventions, is essential for preventing complications, facilitating continued root development in immature permanent teeth and optimizing the preservation of natural dentition. This review systematically exa-mines the pathophysiological changes in pulpal tissues after dental trauma, evaluate techniques for assessing pulp condition, and outlines evidence-based treatment strategies. The objective is to establish a scientific foundation to support clinicians in the standardized diagnosis and management of traumatic dental injuries.

Key words: dental trauma, pulp tissue, endodontic treatment, endodontic disease

中图分类号: 

  • R782.1

图1

年轻恒牙复杂冠折牙髓切断术1例A：术前口内照（正面咬合像）；B：术前口内照（唇面观）；C：术前口内照（切端观）；D：术后即刻口内照，示11牙复合树脂恢复外形，行冠髓切断术；E：术前X线片；F：术后即刻X线片；G：术后6周X线片；H：术后3个月X线片；I：术后半年X线片示11牙牙根继续发育，根尖周未见明显异常。"

图 2

牙外伤后不同牙髓生物学反应下的临床治疗原则牙外伤后临床治疗原则：优先保存活髓，如后续有桩冠修复等治疗需要，可酌情预防性行根管治疗。"

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