多学科联合治疗对成人牙周病患者切牙区牙龈乳头的重建研究

目的:评估多学科联合治疗对成人牙周病患者切牙区牙龈乳头的重建作用。方法:选择19例深覆牙合、不良冠修复致牙周病的患者接受牙周基础治疗、正畸及修复治疗,在全口洁治后获得统一基线,基础治疗后3个月、正畸治疗结束即刻、临时冠修复即刻、6个月及12个月对54颗切牙进行牙周临床检查,比较3个阶段治疗前后的差异。包括:探诊深度(PD),探诊出血(BOP),龈乳头指数(PI),龈乳头高度(PH)。进行χ²检验、非参数秩和检验及单因素方差分析。结果:牙周基础治疗3个月后,11.42%个位点的PD≥4 mm,无PD≥5 mm;95.37%的位点BOP阴性,较基线时明显改善(P<0.05);正畸治疗结束即刻,13.98%个位点的PD≥4 mm,无PD≥5 mm的位点,与牙周基础治疗后3个月的差异无统计学意义;80.56%的位点BOP阴性,与基础治疗后3个月后相比,有统计学差异;临时冠修复即刻、6个月及12个月PD及BOP均无统计学差异;在上述3个时间点PI达到Ⅲ级的龈乳头个数分别为1、8、17,龈乳头完全充盈牙间隙;PI达到Ⅱ级的龈乳头个数分别为13、16、11,差异有统计学意义;PH在3个时间点分别为(1.54±0.54) mm、(2.31±0.56)mm及(3.08±0.50) mm,差异有统计学意义。结论:多学科联合治疗有利于成人牙周病患者切牙牙龈乳头的重建,改善患者前牙区的美学。

Reconstruction of the Incisor Papillae following Interdisciplinary Approach Treatment in Adult Periodontal Patients.

Objective: To evaluate interdisciplinary approach treatment in reconstructing incisor papillae involved periodontal disease with deep overbite and crown restored. Methods: Nineteen adult patients were treated. For each patient, probing pocket depth (PD) and bleeding on probing (BOP) were assessed at baseline,3-month after initial therapy, the end of orthodontic treatment,the bebinning and 6-month and 12-month after temporary crown restored; Papilla index(PI) and papillary height (PH) were assessed only at the back three timepoint. Non-parametric, χ² and One-Way ANOVA tests were carried out for the statistical analysis of the data. Results: Three months after initial therapy, the sites with PD≥4 mm accounted for 11.42% of the observed teeth and 95.37% (103/108) of buccal and lingual sites of the teeth showed negative bleeding on probing, These findings were better than at baseline; At the end of orthodontic treatment, PD≥4 mm accounted for 13.98%, 80.56% BOP showed negative than three months after initial therapy; and there was no difference at the beginning, 6-month and 12-month after temporary crown restored. At the beginning , 6-month and 12-month after temporary crown restored , the levels Ⅲof the PI were 1,8 and 17,the levels Ⅱ were 13,16 and 11,respectively,among the 35 observed papillae,there was statistic difference between them. The heights of gingival papillae measured were (1.54±0.54) mm,(2.31±0.56)mm and(3.08±0.50)mm,these results revealed significant difference. Conclusion: After initial therapy, right selection of indications, interdisciplinary approach and accurate design may reconstruct the interproximal soft tissue, with esthetic improvement of the papillary level.