浙江大学学报（医学版）2025，Vol.54Issue(5)：573-582,10.DOI:10.3724/zdxbyxb-2025-0174
基于修复体-牙-牙周界面治疗风险评估的美学区复杂冠根折修复策略
Restorative strategies for complex crown-root fractures in the esthetic zone:a risk assessment based on the restoration-tooth-periodontium interface
摘要
Abstract
Complex crown-root fractures in the esthetic zone refer to a type of dental trauma occurring in the anterior region,characterized by concurrent fractures involving both the crown and the root,with associated pulp exposure and periodontal tissue injury.These injuries consistently exhibit critical anatomical features,including a fixed palatal fracture location below the alveolar crest,compromised residual tooth structure,and frequent encroachment of the biological width.To predict treatment outcomes,a risk assessment framework based on the restoration-tooth-periodontium interface was developed.Resistance risk was evaluated by assessing the type of residual dentin ferrule and the length of the root within the alveolar bone,while periodontal risk was assessed according to gingival phenotype and alveolar bone morphology.Based on these risk dimensions and the principles of aesthetics,stability,and minimally invasive treatment,a diagnostic classification system was established to categorize fractures into three types:favorable,intervention and high-risk.Type-specific management strategies were proposed:for favorable cases,crown lengthening combined with deep margin elevation to reduce periodontal risk is recommended;for intervention cases,orthodontic extrusion or surgical extrusion is applied to simultaneously address both ferrule deficiency and biological width violation;for high-risk cases,extraction followed by implant restoration is advised due to limited root preservation value.The presented classification enables clinicians to adopt a scientific and structured approach to treatment planning for these complex crown-root fractures in the aesthetic zone.关键词
牙外伤/复杂冠根折/修复体-牙-牙周界面/诊断分型/风险评估/治疗/综述Key words
Dental trauma/Complex crown-root fracture/Restoration-tooth-periodontium interface/Diagnostic classification/Risk assessment/Therapeutic/Review分类
医药卫生引用本文复制引用
孙傲,傅柏平,朱慧勇..基于修复体-牙-牙周界面治疗风险评估的美学区复杂冠根折修复策略[J].浙江大学学报（医学版）,2025,54(5):573-582,10.基金项目
浙江省自然科学基金(LQN25H140008) This study was supported by Natural Science Foundation of Zhejiang Province(LQN25H140008) （LQN25H140008）
