牙冠延长术联合桩冠修复保留后牙残根残冠的疗效分析

目的评价牙冠延长术在后牙牙体缺损达龈下的残根残冠修复中的临床疗效。方法自2009年12月—2011年12月,将48例患者的50颗牙体缺损达龈下的患牙,术前按断端位于龈下最深距离分为A组:距离<3 mm;B组:3 mm≤距离≤4mm;C组:距离>4 mm,均采用牙冠延长术暴露牙体断面,术后6周行桩冠修复。分别记录和比较手术前和手术后6周牙周探诊深度(PD)、龈沟出血指数(SBI)和术后龈缘至牙体断端的距离以观察临床疗效。结果术后6周,A、B 2组病例牙体断端均暴露较好、牙周组织健康,术后修复效果有效率为100%,C组60%患牙断端暴露良好,修复效果尚可,与A、B 2组比较有统计学意义(P<0.05)。术后各阶段3组的PD、SBI均明显优于术前(P<0.05)。A、B 2组术后牙周指数比较差异无显著意义(P>0.05),与C组比较差异有显著意义(P<0.05)。结论牙冠延长术对于保存后牙残根残冠有较好的疗效,但适应证的选择较为关键。

Clinical evaluation of restoring posterior teeth residual roots and crowns with crown lengthening surgery

Objective To evaluate the clinical effects of the crown lengthening surgery on the restoration of posterior residual roots and crowns with subgingivally involved defects.Methods From December 2009 to December 2011,according to the subgingival depths of the defects,50 teeth from 48 patients with subgingivally involved defects were divided into three groups:group A(depth<3.0 mm),group B(3.0 mm ≤depth≤4.0 mm),group C(depth>4.0 mm).All teeth were treated by the crown lengthening first and then post-crown prosthesis 6 weeks after operation.PD,SDI,and lengths from gingival margin to the frature ends of teeth before operation and 6 weeks after operation were recored and compared.Results The teeth sections of AB groups were exposed preferably and the periodontal health was good.The effective rate was 100%.60% of C group were exposed well and were repaired well.There was significant difference between A and C groups,as well as B and C groups(P<0.05).Postoperative PD,and SBI were better than those preoperative values inthree groups(P<0.05).There was no differences between A and B groups in periodontal index after treatment(P>0.05),while there was significant differences between group C and groups A and B(P<0.05).Conclusions Crown lengthening surgery is a good method for the protection and restoration of posterior residual roots and crowns,but dentists should pay attention to the selection of the indications.