4种方法治疗不良烤瓷冠引起的牙龈增生性病变的疗效比较  

Comparison of curative effects between 4 kinds of methods to treat gingival hyperplasia caused by ill PFM

作　　者：杨雷[1] 石旭旭[1] 朴国宾[1] 张天夫[2] 

机构地区：[1]大庆油田总医院口腔科,黑龙江大庆163411 [2]吉林大学中日联谊医院口腔科,吉林长春130033

出　　处：《吉林大学学报（医学版）》2012年第2期341-345,共5页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅自然科学基金资助课题(20125078)

摘　　要：目的:应用高频电刀、CO2激光、微波热凝及传统牙龈成形术治疗由不良烤瓷冠引起的牙龈增生性病变,观察治疗效果,探讨其临床应用价值。方法:将148例不良烤瓷冠引起的牙龈增生性病变患者随机分为高频电刀组、CO2激光组、微波热凝组及传统牙龈成形术组,每组各37例,分别应用上述4种方法进行治疗,恢复重建牙龈生理功能和外观,比较各组患者手术时间、术中失血量、创面愈合时间、临床疗效及美学效果。结果:①与传统牙龈成形术组比较,高频电刀组、CO2激光组及微波热凝组患者手术时间短、术中失血量少、愈合快、感染率低(P<0.01或P<0.05)。②4组患者术后牙龈指数(GI)、龈沟出血指数(SBI)及改良出血指数(mBI)与术前比较明显降低(P<0.01),且高频电刀组、CO2激光组及微波热凝组患者术后GI明显低于传统牙龈成形术组(P<0.05)。③高频电刀组、CO2激光组及微波热凝组患者1年后有效率分别为97.3%、94.6%及97.3%,组间比较差异无统计学意义(χ2=0.34,P>0.05),但均高于传统牙龈成形术组(89.2%)(P<0.05)。结论:采用高频电刀、CO2激光、微波热凝治疗不良烤瓷冠引起的牙龈增生性病变效果确切,效果优于传统牙龈成形术。Objective To study the clinical effects of high-frequency electric knife, CO2 laser, microwave technique and conventional surgery in treating gingival hyperplasia caused by ill porcelain-fused-to-metal （PFM） and explore the values of their ehinical applications. Methods Different types and various degrees of 148 patients with gingival hyperplasia were randomly divided into high-frequency electric knife group, microwave technique group, CO2 laser group, and conventional surgery group, 37 cases in each group. The patients were treated with the 4 kinds of methods mentioned above. Then gingiva was removed and its form was repaired to restore and reconstruct the periodontal physiological function and appearance. Results ①Compared with conventional surgery group, in high- frequency electric knife, CO2 laser, microwave technigue groups, the operative time was shorher, the intraoperative blood loss was lower, the wound healing time was shortened, and the wound infection rates were decreased（P〈0.05 or P〈0.01）. ②）The gingival indexes（GI）, sulcus bleeding indexes（SBI） and modified bleeding indexes（mBI） in 4 groups after operation were significantly decreased compared with before operation（P〈0.01）. The GI in high-frequency electric knife group, CO2 laser group, and microwave technique groups after operation were signifientaly lower than that in conventional surgery group （P〈0.05）. ③ The one-year efficieneies in high-frequency electric knife group, CO2 laser group, and microwave technique group were 97.3%, 94.6%, and 97.3%, there were no significant differences between three groups （X^2= 0.34, P〉 0.05）; but they were sifnificantly higher than that in conventional surgery group （89.2%） （X^2 = 0.54, P〈0.05）. Conclusion High frequency electric knife, CO2 laser, and microwave technique can be effective in the treatment of gingival hyperplasia, and superior to conventional surgery.

关 键 词：牙龈增生性病变 高频电刀 CO2激光 微波热凝 牙龈指数 龈沟出血指数 改良出血指数 

分 类 号：R781.4[医药卫生—口腔医学]