Abstract:

Objective　To analyze the effects of orthodontic treatment and manual reduction combined with arch splint fixation for children with traumatic tooth dislocation. Methods　Sixty children with traumatic tooth dislocation treated at Department of Stomatology, Xi'an Third Hospital from October 2021 to October 2022 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 30 cases in each group. There were 17 boys and 13 girls in the control group; they were (10.12±2.12) years old. There were 16 boys and 14 girls in the observation group; they were (10.76±1.98) years old. The control group took manual reduction combined with dental arch splint fixation, and the observation group orthodontic treatment. The treatment efficacies, incidence rates of complications, periodontal indicators [plaque index (PLI), gingival index (GI), and bleeding index (BI)], treatment satisfaction, and recurrence rates were compared between the two groups. t and χ² tests were used. Results　The total effective rate in the observation group was higher than that in the control group [96.7% (29/30) vs. 80.0% (24/30)], with a statistical difference (χ²=4.043; P=0.044). The incidence rate of complications in the observation group was lower than that in the control group [6.7% (2/30) vs. 26.7% (8/30)], with statistical difference (χ²=4.320; P=0.038). Before the treatment, there were no statistical differences in PLI, GI, and BI between the two groups (all P>0.05). After the treatment, the PLI, GI and BI in the observation group were lower than those in the control group (1.24±0.52 vs. 1.83±0.61, 0.73±0.33 vs. 1.21±0.52, and 0.73±0.33 vs. 1.21±0.40), with statistical differences (t=4.032, 4.269, and 5.070; all P<0.05). The scores of fixation quality, aesthetics, and comfort in the observation group were higher than those in the control group (8.13±1.56 vs. 6.34±1.45, 8.12±1.13 vs. 6.33±1.23, and 7.88±1.11 vs. 5.21±1.34), with statistical differences (t=4.603, 5.870, and 8.405; all P<0.05). The recurrence rates 3 months after the treatment in both groups were 0; the recurrence rates 6 months and 1 year after the treatment in the observation group were lower than those in the control group [3.3% (1/30) vs. 20.0% (6/30) and 6.7% (2/30) vs. 26.7% (8/30)], with statistical differences (χ²=4.043 and 4.320; both P<0.05). Conclusion　Orthodontic treatment for children with traumatic tooth dislocation is effective and can reduce the incidence of complications, maintain periodontal health, and improve the satisfaction, so it is worth being generalized.

Key words:

Orthodontics, Manual reduction combined with dental arch splint fixation, Children, Traumatic tooth dislocation

摘要：

目的　分析口腔正畸与手法复位联合牙弓夹板固定治疗儿童外伤性牙脱位的疗效。方法　采用前瞻性随机对照研究方法。选取2021年10月至2022年10月在西安市第三医院口腔科接收的60例外伤性牙脱位患儿作为研究对象，按照随机数字表法分为对照组（30例）和观察组（30例）。对照组男17例、女13例，年龄（10.12±2.12）岁，采用手法复位联合牙弓夹板固定治疗；观察组男16例、女14例，年龄（10.76±1.98）岁，采用口腔正畸治疗。对比两组患者治疗有效率、并发症发生率、牙周情况（牙菌斑指数、牙龈指数、出血指数）、治疗满意度及复发率。统计学方法采用t检验、χ²检验。结果　观察组治疗总有效率为96.7%（29/30），高于对照组的80.0%（24/30），差异有统计学意义（χ²=4.043，P=0.044）。观察组并发症发生率为6.7%（2/30），低于对照组的26.7%（8/30），差异有统计学意义（χ²=4.320，P=0.038）。治疗前，两组患儿牙菌斑指数、牙龈指数、出血指数比较，差异均无统计学意义（均P>0.05）；治疗后，观察组和对照组牙菌斑指数、牙龈指数、出血指数，固定质量、美观度、舒适度评分分别为1.24±0.52、0.73±0.33、0.73±0.33，（8.13±1.56）分、（8.12±1.13）分、（7.88±1.11）分和1.83±0.61、1.21±0.52、1.21±0.40，（6.34±1.45）分、（6.33±1.23）分、（5.21±1.34）分，两组患者上述指标比较，差异均有统计学意义（t=4.032、5.070、4.269、4.603、5.870、8.405，均P<0.05）。两组患儿治疗后3个月均无复发；治疗后6个月、1年，观察组复发率均低于对照组［3.3%（1/30）比20.0%（6/30）、6.7%（2/30）比26.7%（8/30）］，差异均有统计学意义（χ²=4.043、4.320，均P<0.05）。结论　口腔正畸治疗儿童外伤性牙脱位具有较好的治疗效果，可降低并发症发生率，保持牙周健康，提高满意度，值得推广。

关键词:

口腔正畸, 手法复位联合牙弓夹板固定, 儿童, 外伤性牙脱位