第二磨牙远中龈下缺损龈壁提升后高嵌体修复的短期临床观察

目的:对龈壁提升术用于高嵌体修复第二磨牙远中龈下缺损的效果展开探讨,为临床应用给予借鉴.方法:选取65例存在远中龈下缺损表现的第二磨牙,根管治疗完善后用树脂行龈壁提升,使远中缺损的边缘提升至龈上后铸瓷高嵌体修复,基于改良USPHS标准于修复后l周、半年、1年时开展随访观察,对于边缘密合性、牙体完整性、修复体折裂、边缘着...

Short-term clinical observation of the onlay restorations on the second molars with distal subgingival defects after deep margin elevation

Objective:To evaluate the effect of the onlay restorations on the second molars with distal subgingival defects after deep margin elevation and to provide a reference for clinical application.Methods:After the completion of root canal treatment,65 cases of the second molar with distal subgingival defects were treated with resin filling to elevate the subgingival margin to the superior gingival margin,and were then restored with onlays of cast porcelain.At 1 week,6 months and 12 months after the restoration,the patients were followed up according to the modified USPHS criteria,and the clinical effects were evaluated in three levels:A,B and C for the following seven aspects:marginal tightness,dental integrity,restoration fracture,marginal staining,gingival health,restoration retention and secondary caries.Bleeding index(BI)and periodontal probe depth(PD)of the distal gingival were measured before treatment,and 6 and 12 months after the restoration to evaluate periodontal status.Results:None of the 65 patients lost follow-up,and all of them were rated grade A in seven aspects mentioned above at one week after the operation.At six months after the operation,62 patients were rated as grade A,and two onlays were detached,which have no shedding since the follow-up of re-adhesion,and one patient had mild gingival inflammation,who recovered after enhanced self-cleaning.At twelve months after the operation,59 cases were rated as grade A,with the success rate of 90.8%.There were 2 cases with onlay porcelain fracture and 2 cases with mild gingival inflammation,which showed satisfactory effects in such aspects as marginal tightness,dental integrity,marginal staining,restoration retention and secondary caries.There was no significant difference in BI and PD values before treatment,and 6 and 12 months after the restoration(P>0.05).Conclusion:For the second molars with distal subgingival defects,deep margin elevation has a high clinical success rate,less trauma,simple operation and little impact on periodontal health for onlays restoration of cast porcelain,which can be used as an alternative to crown lengthening surgery when the subgingival defects do not damage the biological width.