牙冠延长术的疗效及影响因素分析  

Prospective study on results of the surgical crown lengthening and its associated factors

作　　者：韩蔚[1] 欧阳翔英[1] 王新知[2] 

机构地区：[1]北京大学口腔医学院牙周科 [2]北京大学口腔医学院牙周科修复科,100081

出　　处：《中华口腔医学杂志》2004年第4期280-283,共4页Chinese Journal of Stomatology

摘　　要：目的 观察牙冠延长术的疗效及影响手术成功的因素,探讨牙冠延长术的适应证。方法 对27颗患牙行牙冠延长术,依手术完成情况分为满意组和姑息组,比较其术前条件、术后4-6周效果,观察在修复后即刻、术后3、6个月的效果及(?)力值。结果 满意组患牙去骨后骨嵴顶至牙断端距离≥4 mm,100％的手术患牙和位点得以暴露。姑息组患牙术前均有位于龈下4-5 mm的位点,去骨后骨嵴顶至牙断端距离<3 mm,术后有29％的手术患牙和16％的位点仍位于龈下,71％(12/17)的患牙术后出现松动,修复后功能恢复不如满意组(P<0.05)。结论 术中暴露4 mm牙体结构,才能获得满意的疗效;患牙断端若位于龈下4-5 mm且有不利的解剖因素等,则不是牙冠延长术的良好适应证。Objective To observe the results of surgical crown lengthening procedure and the factors which affected the success of the surgery. Methods Crown lengthening surgery was performed on 27 teeth. The distance between margin of tooth and bone crest (MT-B) was obtained greater than 4 mm during the surgeries on 10 teeth which were considered as satisfying group. The other 17 teeth were as temporized group with MT-B≤3 mm. The position of the tooth margin was evaluated before surgery, immediately after suturing, and at 4-6 weeks after surgery. The occlusal force and tooth mobility were measured immediately after restoration, at 3 and 6 months after surgery. Results MT-B was abtained≥4 mm and all margins and sites of the teeth were exposed in satisfying group (10/10). At least 1 site with MT-B < 3 mm in tempotized group in which there still were 11 sites (16% ) in 5 teeth (29%) with subgingival tooth margin at 4-6 weeks after surgery. There were more teeth showing increased mobility in temporized group ( 12/17 ) than in satisfying group (1/10) after surgery (P < 0. 05 ). The occlusal force of the teeth after surgery and restoration in temporized group was significantly lower than that of their counterpart teeth (P <0. 01) , but it was not the case in satisfying group (P > 0. 05). Conclusions It is suggested that ideal exposure of tooth margin could be obtained if 4 mm from tooth margin to alveolar crest could be created during the crown lengthening surgery. The teeth both with 4-5 nun subgingival margin sites and factors limiting surgical performance are not the suitable indications for the surgical crown lengthening.

关 键 词：牙冠延长术 疗效 影响因素 手术适应证 生物学宽度 手术方法 

分 类 号：R783[医药卫生—口腔医学]