牙周维护在金属顶盖加覆盖义齿修复中的临床应用

目的 评价牙周维护在金属顶盖加覆盖义齿修复残根残冠伴牙列缺损中的临床意义。方法 选择我科就诊的残根残冠伴牙列缺损患者20例，按顶盖基牙牙周情况分为对照组10例（28颗患牙）：基牙无牙周炎；试验组10例（24颗患牙）：基牙牙周炎较重但还可以保留的。修复前对试验组进行口腔卫生指导、牙周基础治疗以及必要的牙周手术治疗，金属顶盖加覆盖义齿修复后认真牙周维护，定期复查；对照组修复后不进行牙周维护，3个月复查后处理同试验组，检测修复后3、6、12个月顶盖基牙周围菌斑指数（plaque index，PLI）及龈沟出血指数（sulcus bleeding index，SBI），观察牙周维护效果。结果 试验组修复后3、6及12个月时PLI及SBI较基线水平均有明显的下降（P<0.05）；对照组修复后3个月时PLI及SBI较基线水平显著升高（P<0.05），且与试验组3个月时的PLI及SBI相比具有统计学差异（P<0.05）；两组3个月后各指数间无统计学差异性（P>0.05）。结论 牙周维护在金属顶盖加覆盖义齿修复中是不可或缺的重要组成部分。

Clinical application of technique of periodontal maintenance along in repair with metal-coping and casting overdentures

Objective To evaluate clinical effectiveness of periodontal maintenance of prosthetics of residual roots and crowns and dentition defects with restored metal-coping and casting overdentures.Methods Select 20 patients with dentition defects and residual roots and crowns who visited our department.Groups were divided according to periodontal condition of root butment.28 teeth without periodontitis from 10 patients were divided into control group.The other 24 teeth were divided into test group,which were with severe periodontitis but could be reserved.In test group,OHI 、 scaling and root planing and necessary periodontal surgery were carried out on the patients before prosthetics,while periodontal maintenance therapy were needed regularly after repair with metal coping and casting overdenture.Periodontal maintenance was not performed to the control group after repair.then the same treatment as test group were taken 3 months later.PLI and SBI of the overdenture abutment with metal-coping were measured to observe the effectiveness of periodontal maintenance 3、6、12 months after prosthetics.Results 3、6 and 12 months after prosthetics,the PLI and SBI were significantly lower than the base line in the test group(P<0.05),in month after prosthetics,the PLI and SBI of control group were significantly higher than the base line in the control groups(P<0.05),and they were also significantly different with PLI and SBI of test group at that time(P<0.05);there was no statistical significance between the two groups after 3 month later.Conclusions Periodontal maintenance is indispensable in prosthetics with metal-coping and casting overdentures.