Int J Stomatol

Int J Stomatol ›› 2021, Vol. 48 ›› Issue (5): 541-548.doi: 10.7518/gjkq.2021089

• Original Articles • Previous Articles     Next Articles

Clinical effect of surgical extrusion in the treatment of complicated crown-root fracture of anterior teeth

Liao Wenxiao1(),Ma Xindi2,Hong Zhiwei3,Wu Xinyu4,Xing Yundi1,Liu Jingwei5,Chen Lei1()   

  1. 1. Dept. of General Consulting and Oral Emergency, Stomatological Hospital, Southern Medical University, Guangzhou 510220, China
    2. Dept. of Cariology and Endodontics, Affiliated Stomatological Hospital, Suzhou University, Suzhou 215026, China
    3. Dept. of Stomatology, Affiliated Shantou Hospital, Sun Yat-sen University, Shantou Central Hospital, Shantou 515031, China
    4. Dept. of Periodontitis, Panyu Branch, Stomatological Hospital, Southern Medical University, Guangzhou 511400, China
    5. Dept. of Dentistry, Stomatological Hospital, People,s Hospital of Chancheng, Foshan 528000, China
  • Received:2020-12-11 Revised:2021-05-20 Online:2021-09-01 Published:2021-09-10
  • Contact: Lei Chen E-mail:liaowenxiao2011@163.com;13660087016@163.com
  • Supported by:
    Academic Degree and Graduate Education Research Project of National Medical Specialty Graduate Education Steering Committee in 2018(B2-YX20180603-04)

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Abstract:

Objective This study aimed to evaluate the clinical effect of surgical extrusion in the treatment of complicated anterior teeth crown-root fractures. Methods From January 2017 to January 2019, a total of 10 anterior teeth with complicated crown-root fracture were included and surgically extruded in the General Consulting and Oral Emergency Department of Stomatological Hospital, Southern Medical University. Clinical and radiographic parameters including survival rate, periodontal healing, marginal bone loss, and periapical lesion were evaluated. Follow-up period was 1 year. Results All 10 teeth with complicated crown-root fractures survived during follow-up. Radiographic results showed nine cases of healing with normal periodontal ligament and one case of healing with root-surface resorption. The complication of marginal bone loss occurred in two cases. No periapical lesions, inflammatory root resorption, or ankylosis-related replacement resorption was found. Conclusion Surgical extrusion is a safe and feasible method of treating complicated crown-root fractures in anterior permanent teeth.

Key words: complicated crown-root fracture, surgical extrusion, dental trauma, periodontal healing

CLC Number: 

  • R781.05

TrendMD: 

Tab 1

Oral examination and treatment plan of 10 cases with complicated crown-root fracture at first visit"

病例 性别 年龄/岁 外伤时间 就诊时间 面部软组织 患牙 折断线
位置		 牙龈
情况		 旋转
角度/°		 固定方式 根管治疗
时机
1 女 29 2018年12月 外伤后1 h 左侧面颊部、上唇部擦伤,少量渗血、渗液 22 龈下3 mm 龈缘渗血 180 缝合+弹性固定 外伤后14 d
2 女 22 2018年12月 外伤后2周 右侧上唇见结痂 21 龈下4.5 mm 红肿 0 缝合+弹性固定 就诊当天
3 男 26 2017年2月 外伤后1 h 双侧上唇皮下血肿,未见开放性伤口 11 龈下5 mm 龈缘渗血 0 缝合+弹性固定 外伤后14 d
4 男 37 2017年5月 外伤后3 h 双侧上唇皮下血肿,未见开放性伤口 21 龈下3.5 mm 龈缘渗血 180 缝合+弹性固定 外伤后12 d
5 男 30 2017年7月 外伤后2 h 右侧上唇及右侧鼻翼擦伤,少量渗血 12 龈下3 mm 龈缘渗血 180 缝合+弹性固定 外伤后13 d
6 女 45 2017年10月 外伤后2 h 双侧上唇皮下血肿、右侧面颊部擦伤 12 龈下3 mm 龈缘渗血 90 缝合+弹性固定 外伤后14 d
7 男 22 2018年2月 外伤后1 h 上唇及颏部擦伤,少量渗血 21 龈下6 mm 龈缘渗血 45 缝合+弹性固定 外伤后14 d
8 男 33 2018年3月 外伤后0.5 h 上唇擦伤,少量渗血 11 龈下3 mm 龈缘渗血 180 缝合+弹性固定 外伤后13 d
9 女 24 2018年7月 外伤后2 h 上唇皮下血肿,颏部擦伤 11 龈下4 mm 龈缘渗血 0 缝合+弹性固定 外伤后14 d
10 男 36 2018年10月 外伤后2.5 h 右侧上唇擦伤,少量渗血 21 龈下5 mm 龈缘渗血 90 缝合+弹性固定 外伤后14 d

Fig 1

Schematic diagram of periodontal membrane healing"

Tab 2

Clinical and imaging examinations after surgical extrusion"

复诊时间 患牙数/颗 主观症状 正常叩诊音 牙周探诊深度<3 mm 临床松动度检查 牙周膜愈合 表面吸收 炎症吸收 替代性吸收 边缘牙槽骨吸收 根尖骨质密度增高
生理动度 Ⅰ度 Ⅱ度
6~8周 10 0 10 10 0 1 9 10 0 0 0 0 0
3个月 9* 0 9 9 2 6 1 8 1 0 0 1 9
6个月 8** 0 8 8 7 1 0 7 1 0 0 2 8
1年 10 0 10 10 9 1 0 7 1 0 0 2 8

Fig 2

Treatment process of case 1"

Fig 3

Treatment process of case 2"

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