不同排龈方法修复龈下楔状缺损临床疗效观察  

The clinical effect of different gingival retraction methods in subgingival non-carious cervical lesions

作　　者：闫雪冰[1] 彭红[1] 刘利[1] 宋爱平[1] 孙凤[1] 

机构地区：[1]北京大学口腔医学院门诊部特诊科,100034

出　　处：《实用口腔医学杂志》2012年第1期70-73,共4页Journal of Practical Stomatology

摘　　要：目的:评估不同排龈方法修复龈下楔状缺损(楔缺)的临床疗效。方法:选择颈部边缘位于龈下0～2 mm内较难充填的楔缺,分3组:I组:龈边缘位于龈下0～1 mm的楔缺40个,使用排龈线排龈;II组:龈边缘位于龈下0～1 mm的楔缺40个,使用推龈器排龈;III组:龈边缘位于龈下1～2 mm的楔缺20个,使用推龈器排龈;IV组:龈边缘位于龈上的楔缺40个,直接充填,作为对照。各组均使用可乐丽菲露自酸蚀粘接剂粘接,3M Z250树脂进行充填。治疗后1年随访,以改良的USPHS直接临床评价系统评估疗效。数据行卡方检验。结果:I-III组病例修复体均无脱落,对照组有2个脱落。楔缺修复1年后4组成功率差异无显著性;在充填体脱落、边缘适合性、继发龋、边缘着色、新发缺损、牙龈反应及牙髓反应7个方面,4组间差异均无显著性(P>0.05);对于任何一组,基线与1年后复查的差异均无显著性(P>0.05)。结论:在采用有效排龈方法的前提下,龈下楔状缺损的修复可取得满意疗效,颈部边缘于龈下的深度并不影响治疗效果;推龈器的使用对于龈下楔状缺损的治疗有较大帮助。Objective： To evaluate the clinical effect of different gingival retraction methods in the treatment of subgingival non-carious cervical lesions.Methods： The teeth with wedge-shaped defects at subgingival depth of 0-2 mm were selected and divided into 3 groups.40 teeth with the defects at subgingival depth of 0-1 mm in group 1 were restored with the aid of gingival retraction code.40 teeth with the defects at subgingival depth of 0-1 mm in group 2 were restored with the aid of LM gingival retractor.20 teeth with the defects at subgingival depth of 1-2 mm in group 3 were restored with the aid of LM gingival retractor.Additionally,40 teeth with the defects above gingival margins were directly restored as the controls.All the defects were filled with Clearfil SE Bond system and 3M Z250 composite resin.All cases were followed up for 1 year.The results were evaluated by modified USPHS criteria and statistically analyzed using the Fisher＇s exact test.Results：100% retention rates were recorded in the 3 experimental groups,2 restorations of the control groups were lost.No significant differences were detected for one year successful rates among the four groups（P0.05）.There was no significant difference in main indexes including retention,marginal adaptation,recurrent caries,marginal discolor,new defect,gingival response and pulp response（P0.05）.In each group,the parameters of assessment between baseline and 1-year follow-up were not significantly different（P0.05）.Conclusion：With the aid of effective gingival retraction methods,subgingival defects can be satisfactorily restored.The depth of cervical margin does not affect the clinical effects.The LM gingival retractor is valuable for the treatment of the subgingival wedge-shaped defects.

关 键 词：楔状缺损 排龈 临床疗效 自酸蚀粘接剂 

分 类 号：R783[医药卫生—口腔医学]