树脂直接粘接法固定牙周松动前牙的二年效果观察

目的观察牙周炎松动前牙在用树脂直接粘接法固定治疗后二年的临床效果。方法牙周基础治疗后的12例牙周炎患者共计20颗Ⅱ～Ⅲ度松动前牙,采用4-META／MMA—TBB树脂在牙齿邻面将松牙直接粘接固定,定期观察,2年时对粘接固定治疗效果进行评价。观察粘接有无松脱,惠牙动度、探诊深度、附着丧失及牙槽骨高度的变化,用患者自我评分方法评价咀嚼功能的改善和对美观及舒适度的影响。结果18颗牙在二年中无松脱,20个月时2颗拥挤牙咬硬物后粘接松脱,已行再固定。二年时患牙的探诊深度、附着丧失较固定前有所改善（均值分别减少0．57mm、0．47mm,P〈0．05）;牙槽骨高度占根长的百分比与固定前相比平均增加7．04％（P〈0．05）;咀嚼功能评分从固定前的2．92±1．38分升至8．75±1．22分（P〈0．05）,患者对临床美学效果满意,自觉舒适无异物感。结论采用4-META／MMA—TBB树脂直接粘接法固定牙周炎所致松动前牙,具有关观、舒适的特点,二年时粘接效果稳定,牙周状况改善,有助于改善牙齿的咀嚼功能。

Two-year clinical evaluation of direct bonding mobile anterior teeth with 4-META/MMA-TBB resin

Objective To evaluate the effect of direct bonding mobile anterior teeth with 4-META/MMA-TBB resin on improving esthetics and function in 2 years.Methods Twenty periodontal compromised anterior teeth of 12 patients after initial periodontal therapy were included. The mobile teeth were splinted by directly bonding with 4-META/MMA-TBB resin at proximal surfaces of the teeth. Tooth mobility, probing depth (PD), attachment loss (AL) and bone height on radiograph were assessed prior to splinting and 2 years after splinting. All the patients were asked to evaluate the esthetic characteristics after splinting and their chewing function before and after splinting, and to give a score between 0 to 10.Results Eighteen out of 20 teeth were kept stable after splinting for 2 years. No bonding material was seen on labial and lingual surfaces of the teeth. Bonding materials on proximal surfaces appeared transparent and showed better esthetic. At 20 months after splinting, 2 cases with crowed teeth were loosed when they bit hard food and the teeth were reinforced immediately. PD and AL at 2 years after splinting decreased 0.57mm and 0.47mm than those observed at baseline (P＜0.05). Radiograph showed that bone level at 2 years after splinting increased 7.04% than baseline level (P＜0.05). Self-estimation of chewing function scores improved from 2.92±1.38 prior splinting to 8.75±1.22 at 2 years after splinting (P＜0.05). Patients were satisfied with esthetic and felt comfortable with the splints.Conclusion Splinting by direct bonding with the 4-META/MMA-TBB resin was satisfactory in bonding the mobile anterior teeth and had better rehabilitation of masticatory ability and good esthetics.