残根不同断面水平的牙周处理的疗效研究  

Effects and strategy of periodontal therapy on different margin levels of residual tooth

作　　者：陈铁楼 刘国勤 赵海军 张新海 栾伟 季秋杰 刘进 陈骏 张庆福 金晶 

机构地区：[1]上海解放军411医院口腔牙周科,上海200081

出　　处：《口腔医学》2014年第10期746-749,共4页Stomatology

基　　金：上海市卫生和计划生育委员会科研项目(2013-418);上海市虹口区课题(1203-15)

摘　　要：目的探讨残根不同断面水平的牙周处理的疗效作用,分析残根保留牙周手术适应证。方法 85例患者(187颗患牙)入选本研究,根据残根断面位置和牙周手术方式分成三组:治疗1组(T1)67颗,PD≥3 mm,牙槽嵴顶至残根断缘距离≥4mm,实施牙龈切除术;治疗2组(T2)71颗,PD<2 mm,牙槽嵴顶至残根断缘距离<3 mm,实施牙冠延长术;对照组49颗,PD<2 mm,牙槽嵴顶至残根断缘距离<3 mm,实施牙龈切除术;术后常规桩冠修复,观察术前、术后1周、4周、6个月和1年的SBI、GI和松动度,比较各组术后1周和1年成功率。结果残根保存率为97.3%;T1组和T2组在术后各时间点SBI、GI与对照组比较明显降低,在术后6个月和1年时松动牙所占比率比术前降低,对照组在6个月和1年时松动牙所占比率比术前增加;T1组和T2组术后1周和1年成功率显著高于对照组。结论残根不同断面水平采取不同牙周处理对残根保存修复有重要意义,可显著提高成功率。Objective To evaluate the clinical effects and strategy of periodontal therapy on different margin levels of residual tooth to analyze the indications of residual roots reserved. Methods 187 residual roots in 85 cases were included in the study. They were di- vided into three groups according to PD value, margin level of tooth structure to bone （MT-B） , and different periodontal therapeutic strategies ： （ 1 ） Group therapy 1 （ T1 ） ： 67 residual roots with PD ~〉 3 ram, MT-B I〉 4 mm, receiving gingivectomy ; （2） Group therapy 2 （T2） ： 71 residual roots with PD 〈 2 mm and the MT-B 〈 3 mm, receiving crown lengthening surgery; （3） Group control （C） ： 49 re- sidual roots with PD 〈 2 mm and MT-B 〈 3 mm,receiving gingivectomy. SBI,GI and tooth mobility of different groups before operation, 1 week,4 weeks,six months and 1 year after operation were measured. Results The success rate of residual roots was 9＂7.3%. There was significant difference in SBI and GI value when comparing the group T1, T2 with C at different observation points. The tooth mobility ratio of group T1 and T2 decreased at 6 months or 1 year after operation comparing with that before therapy,while that of group C in- creased at 6 months or 1 year after therapy. The success rates of group T1 and T2 were significant higher than group C at 1 week and 1 year after operation. Conclusions Rational periodontal strategy and approach display significant value on different margin levels of re- sidual tooth, which can significantly improve success rate of residual roots reserved.

关 键 词：残根保存 牙冠延长术 牙龈切除术 牙周处理 疗效 

分 类 号：R781.05[医药卫生—口腔医学]