复合树脂高强纤维夹板在晚期牙周炎中的临床应用

目的本研究从循证医学的观点出发，探索复合树脂高强纤维夹板在晚期牙周炎松牙固定及修复中的疗效。方法选择慢性牙周炎患者20名，在牙周基础治疗完善的基础上，利用复合树脂高强纤维夹板固定松动牙，通过临床疗效评定标准以及口腔健康影响量表进行疗效评估。结果治疗后所有患者均感觉口腔功能得到明显提升，生活质量得到明显改善。结论复合树脂高强纤维夹板在晚期牙周炎的松牙固定中具有广泛的应用前景。     

慢性牙周炎患者粘接性牙周夹板固定修复的临床应用研究

目的:观察粘接性夹板固定慢性牙周炎患者松动患牙前、后龈沟液中牙龈卟啉单胞菌和血链球菌的数量变化及牙周状况,以期为评价临床疗效提供参考。方法:选择慢性牙周炎患者19例(76颗松动患牙),记录比较牙周治疗前(基线)、经牙周基础治疗后,采用粘接性牙周夹板固定修复后3、6、12个月的牙周状况(菌斑指数,探诊出血指数、探诊深度、附着丧失)变化;采用电化学测菌法检测龈沟液中牙龈卟啉单胞菌和血链球菌的数量变化;评估患者对夹板固定后美观、功能等方面的满意度。结果:经统计学分析,牙周夹板固定后各时间点的牙周临床指标间差异无统计学意义;牙龈卟啉单胞菌、血链球菌数数量较初诊基线显著减少,差异有统计学意义(P<0.05);牙周夹板固定期间差异无统计学意义(P>0.05)。患者对牙周夹板的美观、咀嚼、发音及舒适的满意度为84.2%以上。结论:慢性牙周炎经牙周基础治疗后,采用粘接性牙周夹板可有效固定松动患牙,使之恢复咀嚼功能;加强口腔健康指导,定期实施牙周维护是影响其治疗效果的重要因素。     

����ֲ�������ϼа�ʽ�������������޸��������ܹ�ȱ��15����Ч����

目的    评价牙周植骨术联合夹板式金属烤瓷联冠修复牙周骨缺损的临床疗效。方法    2008—2009年在新疆医科大学第一附属医院口腔修复科门诊选择患慢性牙周炎伴牙列缺损拟行固定义齿修复的患者15例。应用牙周植骨术联合夹板式金属烤瓷联冠修复基牙牙周骨缺损,随访观察疗效。结果    随访观察6个月,治疗总有效率为93.4%。治疗后6个月的各项牙周指标（PD、CAL、BI）均较治疗前有所改善,治疗前后差异均有统计学意义（P < 0.05）。结论    对于慢性牙周炎伴牙列缺损患者,牙周植骨术联合夹板式金属烤瓷联冠修复基牙牙周骨缺损的近期疗效较佳。     

可摘式钛合金牙周夹板对慢性牙周炎松动牙的固定

目的 探讨可摘式钛合金牙周夹板对慢性牙周炎松动牙的临床固定效果。方法 将30例需做可摘式牙周夹板的慢性牙周炎患者随机分两组，每组15人。即实验组：制作钛舍金牙周夹板23件，固定松动牙115颗；对照组：制作钴铬合金牙周夹板2l件，固定松动牙106颗。戴用夹板前后均以LHLY型牙动度位移测量仪记录患者牙齿松动度数值的变化，用以比较两种牙周夹板的疗效。结果 两组患者分别在戴用牙周夹板1月、3月、半年、1年后进行复查，用测量仪所测牙齿松动度数值均较治疗前不同程度减小，临床有效率均为93％。但钛合金夹板和钴铬合金夹板对牙周病松动牙的固定疗效比较无差异。结论 可摘式钛合金牙周夹板对牙周病松动牙有良好的临床固定效果，是牙周病治疗理想的修复方法。但是钛合金夹板是否比钴铬舍金夹板对牙周病松动牙的固定疗效更好尚需要进一步研究。     

高强纤维牙周夹板配合牙得安牙粉治疗老年中重度牙周病疗效分析

目的:观察牙周基础治疗术后高强纤维牙周夹板固定松动患牙以及牙得安牙粉在维护期内控制老年中重度牙周炎的临床效果。方法:将55例中重度牙周炎患者随机分成实验组27例、对照组28例。实验组为基础治疗后高强纤维牙周夹板固定松动患牙,维护期用牙得安牙粉作日常口腔护理;对照组为基础治疗后尼龙丝牙周夹板固定松动患牙,维护期用普通牙膏作日常口腔护理。观察术前、维护期1个月、6个月牙周指标(PLI SBI PD)的变化和临床疗效以及高强纤维牙周夹板在术后6个月、12个月的松动情况。结果:实验组术前牙周指标与术后1个月、6个月差异有统计学意义(p<0.05);对照组术前牙周指标与术后6个月差异有统计学意义(p<0.05);两组术后1个月的牙周指标相比差异无统计学意义(p>0.05)。两组术后1个月疗效比较无统计学意义(p>0.05)、术后6个月疗效比较有统计学意义(p<0.05)。两种牙周夹板术后6个月均无一例松动、12个月实验组有2例松动,对照组有6例松动,两种夹板的有效率存在显著差异(p<0.05)。结论:牙得安牙粉用于牙周基础治疗术后,其控制牙周炎效果良好。高强纤维牙周夹板用于中重度牙周炎松牙固定疗效确切。     

固定式恒久牙周夹板的临床应用及研究进展

牙周炎患者经过系统治疗后,为了恢复美观和口腔功能,需要对松动牙和缺失牙进行夹板固定和修复治疗。固定式恒久性牙周夹板因具有足够的强度以及良好的美观性,已成为临床上常用的修复方法。现将近年来这方面的研究进展做一综述,并提出今后夹板修复过程中需进一步完善的问题。     

3种牙周夹板的修复治疗效果评价

目的:比较弯制式、铸造支架式及套筒冠式牙周夹板在重度牙周炎松动牙齿固定后修复治疗的临床效果。方法:选取60例重度牙周炎患者,按随机数字表法分为弯制组、铸造组和套筒冠组,每组各20例。各组患者均在系统的牙周基础治疗后,对松动牙制作相应牙周夹板进行固定,并保持每年2次牙周洁治、刮治。分别记录治疗前、治疗后6、12、24个月患牙的探诊深度、附着丧失水平、牙齿松动度等临床数据。结果:经牙周夹板修复后,各组患者探诊深度、附着丧失水平、牙齿松动度均显著改善(P<0.05),其中套筒冠组的修复效果优于铸造组(P<0.05),而铸造组的效果优于弯制组(P<0.05)。结论:3种恒久性牙周夹板均对维持牙周健康有利,且可有效固定松动患牙,其中以套筒冠式牙周夹板效果显著。     

套筒冠式夹板在慢性重度牙周炎治疗中的临床应用

目的 观察并评价套筒冠式夹板固定慢性重度牙周炎松动牙的临床疗效。方法 选择慢性重度牙周炎患者16例(93颗),在完善的牙周基础治疗(1例手术治疗)后,采用套筒冠式夹板固定松动牙,经2年追踪观察,观察牙龈状况,牙周袋深度,牙齿松动度,骨密度变化,询问并纪录患者的主观感受。结果 16例患者,第1年的成功率93.55%,第2年的成功率为90.32%。结论 慢性重度牙周炎,经牙周序列治疗并结合套筒冠式牙周夹板固定松动牙,可提高牙周病的治疗成功率。     

高强纤维牙周夹板固定重度牙周炎松动牙的疗效评价

目的:评价高强纤维牙周夹板固定重度牙周炎松动牙的临床效果.方法:选取符合病例纳入标准的30例重度牙周炎患者的104颗患牙,按随机数字表法分成实验组(15例,58颗患牙)和对照组(15例,46颗患牙).实验组在基础治疗后,以高强纤维牙周夹板固定松动患牙;对照组在基础治疗后,以结扎丝牙周夹板固定松动患牙,经过3个月～1 a的临床观察,检查记录松动患牙的探诊深度(probing depth,PD)、附着丧失程度(attachment loss,AL),龈沟出血指数(sulcus bleeding index,SBI)和菌斑指数(plaque index,PLI)4项牙周指标,以及固定夹板的完好率.采用SPSS13.0软件包对数据进行统计学分析.结果:实验组固定6个月后,PD、AL较固定前显著改善(P＜0.05);SBI、PLI在固定3、6、12个月后,与固定前比较无显著差异.对照组固定6个月后,PD、AL较固定前显著改善(P＜0.05),SBI、PLI在固定6个月后高于固定前(P＜0.05).固定后3个月,牙周各项指标在2组间无显著差异(P＞0.05).固定6个月后,实验组与对照组的PD、AL无显著差异,对照组的SBI和PLI较实验组高,差异有统计学意义(P＜0.05).结论:高强纤维牙周夹板用于重度牙周炎松动牙固定疗效确切,对维持牙周健康有利,不妨碍菌斑控制.     

金属烤瓷联冠固定夹板治疗重度牙周病的疗效

目的:用金属烤瓷联冠固定夹板把重度牙周病的松动牙固定起来,增强患者的咀嚼能力,促进牙周健康的恢复。方法:在已经接受了全面牙周治疗的基础上,合理设计金属烤瓷联冠,把松动牙固定起来,比较固定前后的咀嚼功能,观察患牙治疗前、治疗后6个月、2年、4年的菌斑指数、龈沟出血指数、牙周探诊深度、牙周附着水平等临床指标的变化。结果:19例患者的咀嚼能力均得到改善,84.2%达到良好,治疗前后的菌斑指数、龈沟出血指数、牙周探诊深度均有显著改变,牙周附着水平无改变。结论:金属烤瓷联冠是作为牙周夹板治疗重度牙周病较理想的方法。     

树脂夹板固定牙周病松动前牙疗效的综合评价

目的：采用多项客观指标与主观指标相结合的方法,综合评价尼龙丝加强树脂夹板固定牙周炎松动前牙的临床疗效。方法：16例重度牙周病病例牙周基础治疗后,制作16例尼龙丝加强树脂夹板,固定II°～III°松动的牙周病前牙：分别于术后3月、6月观察牙周指数、咬[牙合]力、x线根尖片和患者主观满意度。结果：患牙的PD、CAL值在术后3月、6月均显著下降（P〈0.01）,基牙的PD、CAL值在术后3月显著下降（P〈O．01）,夹板完成后咬合力显著增强（P〈O．01）：主观满意度评分显示疗效肯定（P〈O．01）：全部病例牙槽骨无继续吸收,其中11例患者骨量有一定程度增加。结论：综合分析评价表明,尼龙丝加强树脂夹板固定牙周病松动前牙,可获得较满意的临床疗效和较高的患者接受度。     

慢性重度牙周炎松动前牙的非手术治疗评价

目的：观察牙周基础治疗联合牙松动固定和维护治疗,对慢性重度牙周炎松动下前牙的治疗效果。方法15例慢性重度牙周炎患者,每例患者选出1~2颗松动Ⅱ度以上的下颌切牙,共20颗。按牙周基础治疗、树脂夹板牙周固定、牙周袋深部刮治、维护治疗的顺序进行治疗。治疗后3、6、12个月对治疗效果进行评价。观察患牙龈沟出血指数、探诊深度、附着丧失的变化。结果治疗后所有患者均感觉咬合功能得到提升。3、6、12个月复查,患牙出血指数、探诊深度、牙周附着水平较基线有明显改善（P<0.01）。结论慢性重度牙周炎松动前牙经非手术治疗,症状缓解,外观明显改善。     

两类夹板固定重度牙周病松动前牙的疗效分析

目的：采用多项主客观指标结合的方法,评价金属烤瓷冠桥、尼龙丝加强树脂夹板固定重度牙周病松动牙的各自临床特点,为夹板类型的选择提供重要参考。方法：松动Ⅱ~Ⅲ度的牙周病前牙,经牙周基础治疗后,制作完成金属烤瓷冠桥和尼龙丝加强树脂夹板各10例,评价其客观指标牙周检查指数、咬合力、X线片和主观满意度6个月的临床疗效。结果：6个月后两组夹板基牙的PD值均有明显下降,咬合力显著升高,X线片显示骨密度和高度有一定程度的增长,并且获得满意的主观接受度。结论：两类夹板是保存重度牙周炎松动前牙的可靠、有效的方式,但必须长期坚持牙周维护以稳固疗效。     

Risk indicators for future clinical attachment loss in adult periodontitis. Tooth and site variables.

In an earlier report, we examined the relationship of patient-derived clinical and epidemiological variables to the risk for future clinical attachment loss (CAL) in chronic adult periodontitis. We determined that the extent of the patient's existing periodontal disease as measured by mean attachment loss (MAL) and the patient's age were the most important patient-derived risk indicators for CAL among those factors evaluated. In this study, we examined the tooth and site variables that were associated with CAL. Seventy-five patients with chronic adult periodontitis were followed for 6 months. Clinical data at baseline, including attachment level and probing depth, were obtained from six sites per tooth. The hazard rate for CAL at all sites was 2.0%, and 4.1% of teeth displayed at least one site with CAL. Mandibular and maxillary molars and maxillary premolars displayed the highest incidence of CAL (6.1%, 5.6%, 5.5%, respectively), while maxillary anterior teeth (1.8%) and mandibular premolar teeth (2.1%) demonstrated the lowest incidence. The greatest number of sites demonstrating CAL had an existing attachment level of 4 to 7 mm and a probing depth of less than or equal to 5 mm. When the data were converted to hazard rates, however, an increase in hazard rate was seen with increasing existing attachment loss or probing depth. When MAL was considered, patients with mild and moderate periodontitis demonstrated a relatively low incidence of CAL at sites with less than or equal to 7 mm of existing attachment loss. Patients with severe periodontitis exhibited greater hazard rates for sites with 0 to 3, 4 to 5 and 6 to 7 mm of existing attachment loss.(ABSTRACT TRUNCATED AT 250 WORDS)     

Clinical characteristics of periodontal sites with probing attachment loss following initial periodontal treatment

Abstract Periodontal sites which had undergone probing attachment loss were identified in 16 advanced periodontitis patients subjected to initial periodontal treatment and monitored every 3rd month for 42 months. Many sites with probing attachment loss showed no increase in probing depth and bled on probing at a few of the examinations during maintenance. Others showed increase in depth, frequent bleeding and suppuration. An arbitrary classification of ‘questionable periodontitis’ sites was used and included sites with the following characteristics: probing depth at 42 months 3.5 mm + bleeding on probing at no more than 5 of the 14 examinations 3-42 months + no suppuration on probing 3-42 months. The % sites in this category ranged from 21-35%, depending upon method used to determine probing attachment loss. Widely varying characteristics of sites identified with probing attachment loss were evident for all surface locations and all subgroups of initial probing depth. From a traditional viewpoint, a significant proportion of the losing sites might not have been afflicted with periodontitis. On the other hand, deterioration does not necessarily have to be coupled with obvious inflammation, particularly following therapy.     

Histologic and clinical evaluation of an allogeneic bone matrix for the treatment of periodontal osseous defects

The objective of this study was to evaluate the potential of an allogeneic bone matrix (Grafton, Osteotech) to regenerate new bone, new cementum, and a new periodontal ligament around teeth previously contaminated by bacterial plaque. Four patients with chronic advanced periodontitis and who were scheduled for full-mouth extraction were enrolled in the study. One patient dropped out from the study before any therapy began. One tooth with an intraosseous defect in each patient was selected for treatment. Measurements of probing depth, gingival recession, and clinical attachment level were made. After flap reflection, a root notch was placed at the apical level of calculus, the root was debrided, and allogenic bone matrix was inserted into the defect. After 6 months of healing, the teeth were removed en bloc and evaluated histologically for a new attachment apparatus. Two of the three teeth demonstrated regeneration of new bone, cementum, and periodontal ligament.     

Association between signs of trauma from occlusion and periodontitis

The purpose of this study was to evaluate the association between signs of trauma from occlusion, severity of periodontitis and radiographic record of bone support. The maxillary first molars of 300 individuals were independently evaluated by two examiners for signs of trauma from occlusion, pattern or occlusal contacts and severity of periodontitis. Each site was also evaluated radiographically by an independent third examiner. The results indicated that: teeth with either bidigital mobility, functional mobility, a widened periodontal ligament space or the presence of radiographically visible calculus had a deeper probing depth, more loss of clinical attachment and less radiographic osseous support than teeth without these findings, teeth with occlusal contacts in centric relation, working, nonworking or protrusive positions did not exhibit any greater severity of periodontitis than teeth without these contacts, teeth with both functional mobility and radiographically widened periodontal ligament space had deeper probing depth, more clinical attachment loss and less radiographic osseous support than teeth without these findings and given equal clinical attachment levels, teeth with evidence of functional mobility and a widened periodontal ligament space had less radiographic osseous support than teeth without these findings.