二种术式对牙体缺损达龈下患牙牙龈修整后的疗效评价

目的 比较牙冠延长术与牙龈切除术对牙体缺损达龈下患牙的牙龈修整后的临床疗效.方法 选取186颗松动度(MD)≤Ⅰ度、牙体缺损达龈下1.5～4.0mm的上颌前牙,按缺损最深位点处的探诊深度(PD)分为浅缺损组(94颗患牙,PD＜2.5mm)和深缺损组(92颗患牙,PD 2.5～4mm).每组患牙均分,分别采用牙龈切除术和牙冠延长术进行牙龈修整术,术后2周常规修复,术后12个月回访.分别记录术前、术后2周及12个月后三个时点的PD、MD和龈沟出血指数(SBI),所得数据用单因素方差分析进行统计分析.结果 在浅缺损组,二种术式均可显著降低PD和SBI(P＜0.05),同时二种术式中MD均增加(P＜0.05),但二种术式之间PD和SBI的降低和MD的增加差异均无统计学意义(P＞0.05).在深缺损组,牙冠延长术组PD和SBI的降低值均高于牙龈切除术组(P＜0.05),但前者MD增加的数值较后者明显(P＜0.05).结论 当牙体缺损位于龈下且不侵犯生物学宽度时,可采用牙龈切除术进行牙龈的修整;当牙体缺损位于龈下且侵犯生物学宽度时,采用牙冠延长术修整牙龈疗效较好,但因术后MD有增大趋势,故选择适应症时应慎重.

RESTORATIVE EFFECTS OF GINGIVECTOMY AND PROLONGATION OF DENTAL CROWN ON DEEP-SEATED SUBGINGIVAL TEETH FRACTURE

Objective To compare the restorative effects of crown lengthening surgery and gingivectomy on dowel crown of deep-seated subgingival teeth fracture.Methods One hundred and eighty-six teeth,with defect subgingivally from 1.5 mm to 4.0 mm,mobility degree(MD)≤ I degree,were divided into two groups based on PD of pre-operation.The groups were as follows: minor defect group(<2.5mm)and major defect group(2.5 to 4mm).Each half of the two groups were selected and divided into the crown lengthening surgery group and gingivectomy group,and then restored 2 weeks after operation.The clinical effects were compared by measuring the parameters of MD,sulcus bleeding index(SBI)and maximal defect probing depth(PD)at different times respectively.The results were evaluated by One-way ANOVA.Results In minor defect group,the effective rate of the gingivectomy group and the crown lengthening surgery group was no significantly difference(P>0.05);In major defect group,the effective rate of the crown lengthening surgery group was significantly higher than that in the gingivectomy group(P<0.05),but a significant increase of MD occurred in the crown lengthening surgery group twelve months after operation.Conclusion Both crown lengthening surgery and gingivectomy can conserve teeth with sublingually involved defect,and crown lengthening surgery has a good,long-time clinical effect in major defect cases.But MD showed an in creasing trend after operation in crown lengthening surgery,so the indication must be selected properly.