Int J Stomatol ›› 2021, Vol. 48 ›› Issue (6): 675-682.doi: 10.7518/gjkq.2021083

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Evaluation of pulp status and selection of treatment in young permanent teeth after trauma

Gao Huihui1(),Deng Shuli2,He Xinmin2,Hu Ji,an2()   

  1. 1. Dept. of Dentistry, School of Medicine, Zhejiang University, Dept. of Cariology and En-dodontics, The Affiliated Stomatological Hospital, School of Medicine, Zhejiang University, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310006, China
    2. Dept. of Cariology and Endodontics, The Affiliated Stomatological Hospital, School of Medicine, Zhejiang University, Key Laboratory of Oral Biomedical Research of Zhe-jiang Province, Hangzhou 310006, China
  • Received:2020-12-10 Revised:2021-05-14 Online:2021-11-01 Published:2021-10-28
  • Contact: Ji,an Hu;
  • Supported by:
    National Health and Family Planning Commission Fund(WKJ-ZJ-1624);Zhejiang Education Department of General Scientific Research Project(Y201942154)


Tooth trauma is the damage of hard tissue and (or) periapical tissue caused by external force. It may induce pathological changes of dental-pulp tissue, thereby affecting the prognosis and long-term preservation of the affected teeth. In particular, permanent teeth have the unique anatomical and physiological characteristics of incomplete root deve-lopment, large apical foramen, and adequate blood supply. Once young permanent teeth suffer from trauma, the treatment of the affected teeth becomes greatly challenging. It also provides a physiological basis for the preservation of living pulp and pulp regeneration. In this paper, we review the different pulp states of young permanent teeth after trauma and the corresponding vital-pulp preservation treatment to provide a basis for oral clinicians to select the appropriate treatment stra-tegy.

Key words: tooth trauma, immature permanent teeth, dental-pulp state, vital pulp therapy

CLC Number: 

  • R781.33


Tab 1

Treatment methods under different dental pulp conditions in common young permanent tooth trauma types"

项目 硬组织损伤 牙周组织损伤
简单冠折 复杂冠/冠-根折 牙震荡 不完全脱位损伤 全脱位损伤 嵌入型损伤
1)露髓孔直径<0.5 mm、时间短、断面干净:DPC[28];
2)露髓孔直径>0.5 mm、暴露时间长:活髓切断术
临床检查:牙冠颜色、叩诊、松动度、根尖周是否有窦道/瘘管、牙髓活力测试等 影像学检查:根尖周组织及牙根发育情况、是否存在牙根吸收、髓腔闭锁等
牙髓炎:根据炎症范围采用牙髓切断术[36] 牙髓坏死及根尖周病变:1)当牙根长度<2/3、根尖孔直径>1 mm时,行牙髓血运重建术[56];2)根尖孔直径0.5~1.0 mm、患牙有足够的根管壁厚度及长度,行根尖诱导成形术[45,46];3)牙根发育接近完成,根尖孔直径<0.5 mm或已行牙髓血运重建术及根尖诱导成形术后未形成明显根尖止点时,行根尖屏障术
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