引导牙周组织再生在伴牙槽骨缺损牙再植术中应用的回顾性研究

目的 :回顾分析配合引导性组织再生术 (guidedtissueregeneration ,GTR)治疗对伴牙槽骨缺损的脱位再植牙的临床疗效的影响 ,为引导牙周组织再生的进一步研究提供经验。方法 :收集 1996年～ 2 0 0 3年间伴牙槽骨缺损、再植术中配合了GTR术治疗的完整病历资料 ,对其临床治疗情况及近远期疗效作回顾性研究分析。结果 :共收集到 2 3份符合条件的病历 (6 4颗再植牙 ) ,疗效分析结果表明 ,患牙术后 12个月探诊深度均显著减少 ,附着水平均显著获得 ;无论脱位时间长短 ,术后牙松动、牙根吸收和失牙的发生率均较高。伤后 6h内就诊脱位牙直接再植后 ,牙髓坏死率 77.5 % ,牙根吸收和失牙率与伤后就诊超过 6h组有显著性差异 (P <0 .0 1)。结论 :伤后就诊时间影响再植牙治疗效果 ,配合单纯GTR治疗 ,伴牙槽骨缺损的脱位再植牙的远期疗效仍然较差 ,利用GTR技术促进牙周组织再生特别是促进牙周缺损的再生需要进一步的基础与临床研究。

Retrospective Study of the Clinical Treatment Results of Luxationial Tooth with Alveolar Bone Furcation Defects Received Guided Periodontal Tissue Regeneration

Objective: To observe and analyse the clinical treatment results of luxational tooth with alveolar bone furcation defects received guided tissue regeneration(GTR), then to provide some clinical experience to the study of guided periodontal tissue regeneration in periodontal tissue engineering. Methods: The clinical treatment results of 23 cases (64 teeth) from 1996 to 2003 reviewed retrospectively. All cases are received GTR treatment during tooth replantation, and all luxationial teeth with alveolar bone defects in at least a orientation of the alveolar cavity. Results: 12 months later, clinical measurements showed significant attachment gain (AG), significant decrease of probing depth (PD) of all teeth received GTR treatment. Although the root resorption and tooth loss related closely with the time between injury and treatment, the rates of pulp necrosis and root resorption of luxational tooth with alveolar bone furcation defects are all showed significant differences compared with the previous reports. The alveolar bone defects cannot gain ideal regeneration even after a long period of time. The tooth loss rate is even higher. Conclusion: GTR treatment may be a effect treatment method of tooth replantation, but some special cases such as luxational tooth with alveolar bone furcation defects can't achieve good effect only by GTR treatment. How to improve the treatment effect of this kind of luxational teeth and how to improve the regeneration of periodontal tissues needs further study.