완전탈구 후 재식한 영구 절치의 예후에 대한 후향적 연구
Prognosis of Replanted Permanent Incisors after Avulsion Injury: A Retrospective Study
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참고문헌
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초록
지금까지 완전탈구된 치아의 예후에 대해 많은 연구가 발표되었으나, 국내의 소아와 청소년을 대상으로 한 추적 조사 연구는 거의 없다. 이에 본 연구에서는 6-14세 환자 142명의 재식치 184개를 대상으로 전자의무기록지와 치근단 방사선 사진을평가함으로써 재식된 영구 절치의 치유와 예후에 영향을 미치는 인자에 대해 분석하였다. 재식치의 치근 발육 단계가 낮을수록 치수의 재혈관화 가능성이 높았다. 구외 시간이 60분 이상인 경우 염증성 치근 흡수의 발생률은 미성숙 치아에서 높게 나타났으며, 대치성 치근 흡수의 발생률은 성숙 치아에서 높게 나타났다. 20일 이상 경과하여 발수한 경우 염증성 치근 흡수의 발생률이 증가하였으며, 대치성 치근 흡수에 비해 염증성 치근 흡수가 생존 기간의 감소에 더 큰 영향을 미치는 것으로 나타났다. 치근의 발육 단계와 재식치의 생존 기간 간에 상관관계는 없었으나, 대치성 치근흡수가 발생한 경우 미성숙 치아의 생존 기간은 성숙 치아에 비해 짧았다. 본 연구는 장기간의 추적 조사를 통해 수행한 연구로서, 완전탈구된 치아의 치료 지침과 예후 평가에 대한 기초 자료로 활용될 수 있으리라 생각된다.
Abstract
Many studies on the prognosis of avulsed teeth were published but follow-up studies on Korean children and adolescents are insufficient. The aim of this study was to identify clinical factors determining the healing and prognosis of permanent incisors that were replanted after avulsion injury. This study included 184 permanent teeth in 142 patients aged 6-14 years. The clinical and radiographic data of the patients were analyzed from electronic medical records. Immature teeth had a higher probability of pulp revascularization than mature teeth. When extra-alveolar time was longer than 60 minutes, the incidence of inflammatory root resorption (IRR) was higher in immature teeth than mature teeth. However, the incidence of replacement root resorption (RR) was higher in mature teeth than immature teeth under the same condition. The incidence of IRR was increased when pulp was extirpated more than 20 days after replantation. IRR had a more significant influence on the decrease of survival expectation than RR. There was no significant correlation between the root development stage and survival expectation. However, when RR occurred, immature teeth survived shorter than mature teeth. Long term follow-up results from this study are expected to be used as fundamental data for the treatment guidelines and evaluation of the prognosis of replanted teeth.
참고문헌 (33)
- Andreasen JO, "Etiology and pathogenesis of traumatic dental injuries. A clinical study of 1,298 cases", Scand J Dent Res, 78, pp.329~342 (1970)
- Petrovic B, "Factors related to treatment and outcomes of avulsed teeth", Dent Traumatol, 26, pp.52~59 (2010)
- Goldbeck AP, "Replantation of an avulsed permanent maxillary incisor with an immature apex : report of a case", Dent Traumatol, 24, pp.120~123 (2008)
- Flores MT, "Guidelines for the management of traumatic dental injuries. II. Avulsion of permanent teeth", Dent Traumatol, 23, pp.130~136 (2007)
- Trope M, "Clinical management of the avulsed tooth. Present strategies and future directions", Dent Traumatol, 18, pp.1~11 (2002)
- 이동우, "재식된 상악 중절치의 장기간에 걸친 추적례", 대한소아치과학회지, 31(4), pp.729~733 (2004), 대한소아치과학회
- 강유진, "외상으로 유착된 영구 전치에서의 치관 절제술", 대한소아치과학회지, 37(2), pp.252~259 (2010), 대한소아치과학회
- Andreasen JO, "Replantation of 400 avulsed permanent incisors. 1. Diagnoses of healing complications", Endod Dent Traumatol, 15, pp.51~58 (1995)
- Line SE, "Relationship between periodontal injury, selective cell population and ankylosis", J Periodontol, 45, pp.725~730 (1974)
- Andersson L, "International association of dental traumatology guidelines for the management of traumatic dental injuries : 2. Avulsion of permanent teeth", Dent Traumatol, 28, pp.88~96 (2012)
- Andreasen JO, "Periodontal healing after replantation and autotransplantation of incisors in monkeys", Int J Oral Surg, 10, pp.54~61 (1981)
- Andreasen JO, "Replantation of 400 avulsed permanent incisors. 4. Factors related to periodontal ligament healing", Endod Dent Traumatol, 11, pp.76~89 (1995)
- Tzigkounakis V, "Retrospective clinical study of 90 avulsed permanent teeth in 58 children", Dent Traumatol, 24, pp.598~602 (2008)
- Pohl Y, "Results after replantation of avulsed permanent teeth. III. Tooth loss and survival analysis", Dent Traumatol, 21, pp.102~110 (2005)
- Soares AJ, "Relationship between clinical radiographic evaluation and outcome of teeth replantation", Dent Traumatol, 24, pp.183~188 (2008)
- Barrett EJ, "Survival of avulsed permanent maxillary incisors in children following delayed replantation", Endod Dent Traumatol, 13, pp.269~275 (1997)
- Moorrees CFA, "Age variation of formation stages for ten permanent teeth", J Dent Res, 33, pp.325~335 (1963)
- Andreasen JO, "Replantation of teeth. I. radiographic and clinical study of 110human teeth replanted after accidental loss", Acta Odontol Scand, 24, pp.264~286 (1966)
- Tronstead L, "Root resorption : etiology, terminology and clinical manifestations", Endod Dent Traumatol, 4, pp.241~ (1988)
- Andersson L, "Tooth avulsion and replantation", Dent Traumatol, 23, pp.129~ (2007)
- Wang SH, "Continued root formation after replantation and root canal treatment in an avulsed immature permanent tooth : a case report", Dent Traumatol, 26, pp.182~185 (2010)
- Andreasen JO, "Replantation of 400 avulsed permanent incisors. 2. Factors related to pulpal healing", Endod Dent Traumatol, 11, pp.59~68 (1995)
- Trope M, "Avulsion of permanent teeth : theory to practice", Dent Traumatol, 27, pp.281~294 (2011)
- Kling M, "Rate and predictability of pulp revascularization in therapeutically reimplanted permanent incisors", Endod Dent Traumatol, 2, pp.83~89 (1986)
- Pohl Y, "Results after replantation of avulsed permanent teeth. II. Periodontal healing and the role of physiologic storage and antiresorptive-regenerative therapy", Dent Traumatol, 21, pp.93~101 (2005)
- Andreasen JO, "Textbook and color atlas of traumatic injuries to the teeth", pp.632~ (2007), Mosby
- Kinirons MJ, "Inflammatory and replacement resorption in reimplanted permanent incisor teeth : a study of the characteristics of 84 teeth", Endod Dent Traumatol, 15, pp.269~272 (1999)
- Hinckfuss SE, "An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part I : Timing of pulp extirpation", Dent Traumatol, 25, pp.158~164 (2009)
- Andersson L, "Progression of root resorption following replantation of human teeth after extended extraoral storage", Endod Dent Traumatol, 5, pp.38~47 (1989)
- Stewart CJ, "Factors affecting the timing of pulp extirpation in a sample of 66 replanted avulsed teeth in children and adolescents", Dent Traumatol, 24, pp.625~627 (2008)
- Oikarinen K, "Tooth splinting : A review of the literature and consideration of the versatility of a wire composite splint", Endod Dent Traumatol, 6, pp.237~250 (1990)
- Hinckfuss SE, "Splinting duration and periodontal outcomes for replanted avulsed teeth : a systemic review", Dent Traumatol, 25, pp.150~157 (2009)
- Andreasen JO, "Textbook and color atlas of traumatic injuries to the teeth", pp.383~425 (1994), Mosby