龈下残根正畸牵引后桩冠修复12例疗效分析  

Pivot crown restoration after orthodontic traction of subgingival residual root in 12 cases

作　　者：朱静涛[1] 于新[1] 刘奕[1] 

机构地区：[1]中国医科大学口腔医学院奉天门诊部,辽宁沈阳110013

出　　处：《中国实用口腔科杂志》2010年第8期472-473,共2页Chinese Journal of Practical Stomatology

基　　金：辽宁省教育厅科研项目计划(L2010670);辽宁省科学技术计划项(2009225010-27)

摘　　要：目的探讨龈下残根正畸牵引后桩冠修复可行性。方法 2007—2009年中国医科大学口腔医学院修复门诊转诊至正畸科的严重牙体缺损病例12例(12颗牙),其龈下残根(牙根长度足够)经完善的根管治疗后先行纤维桩树脂桩核修复,在树脂核上黏接正畸托槽,使托槽尽量靠近龈方,在残根近远中4～6颗牙(每侧2～3颗牙)上黏接托槽,将一段长度适中的镍钛弓丝结扎固定在托槽上,利用弓丝的弹性形变复位达到牵引残根的作用。按桩冠要求制备基牙,修整桩核,制备烤瓷冠,使修复后的烤瓷冠边缘与根面缺损区边缘完全密合,完成修复。结果修复2年后桩冠修复体仍然固位稳定,根冠边缘密合,无松动、叩痛,牙龈无明显增生、炎症,牙周组织健康。X线检查根尖周围组织正常,无根尖周阴影,根尖周牙周膜连续,无骨质吸收,无牙槽骨吸收,牙根无复发回缩。结论龈下残根经正畸牵引后行桩冠修复是可行的。Objective To investigate the possibility of restoring the pivot crown after orthodontic traction of subgingiva residual root.Methods Subgingival residual root （root length enough） has been cured by a complete root canal treatment,and then restored by fiber post,resin post and core.The bracket was bound to the resin core while keeping the bracket as close to the gingival as possible.Four to six teeth were bound with the brackets ,the mesiocclusion and distocclusion of the residual root（2-3 teeth on each side）.Fix a moderate length of nickel-titanium arch wire to the brackets,and the elastic deformation of arch wires was used to tract residual root.Prepare the abutment according to the requirement of pivot crown,finish post and core and prepar the crown,so that the root surface edge was completely sealed with restored crown.The repair was completed.Results Two years later,crown restoration prosthesis remained stable and the edge of the root and crown was sealed.No loose,no percussion pain,no significant gingival hyperplasia and inflammation.Periodontal tissues were healthy.X-ray showed no apical shadow with continuous apical periodontal ligament;no bone absorption;no loss of alveolar bone;no recurrence root retraction.Periapical tissue was normal.Conclusion Pivot crown restoration after orthodontic traction of subgingival residual root is feasible.

关 键 词：龈下残根 桩冠 正畸牵引 

分 类 号：R78[医药卫生—口腔医学]