牙体缺损达龈下前牙行牙冠延长术后冠修复的临床效果  

Clinical effect on the subgingival tooth defect of the anterior teeth crown after surgical crown lengthening

作　　者：卢文博[1] 王京阳[1] 

机构地区：[1]中国中医科学院广安门医院口腔科,北京100053

出　　处：《中国医药导报》2015年第1期52-55,共4页China Medical Herald

摘　　要：目的：对前牙牙体缺损达龈下的患者行冠延长术，探讨冠延长适应证、手术方法及术后修复方法和效果。方法收集2009年6月～2013年3月于中国中医科学院广安门医院就诊的前牙牙体缺损达龈下患者36例（41颗患牙），行牙冠延长术，牙体缺损位于龈下〈2 mm，采用龈切除术；牙体缺损位于龈下2～4 mm，采用翻瓣去骨及骨成形术，术后6~8周行全冠修复。比较修复效果及修复前后龈沟出血指数（SBI）、菌斑指数（PLI），松动度（TM）、延长出的冠高度、黑三角发生率。结果①41颗患牙的牙体缺损断面术后均暴露，无松动；1年后仅1例出现冠脱落，其余良好。②术后6、12周SBI（0.98，0.76）、PLI（0.70，0.44）低于术前（2.35，1.52），TM（0.65，0.52）高于术前（0.37），差异有统计学意义（P〈0.05）。③术后6周[（3.02±0.51）mm]、12周[（3.24±0.59）mm]延长出的冠高度均高于术后2周[（2.35±0.46）mm]，差异有统计学意义（P〈0.05）。④修复即刻（78.05%）、修复后6个月（21.95%）、修复后12个月（19.51%）黑三角发生率差异有统计学意义（P〈0.05）。⑤修复后12个月SBI（1.14）、PLI（0.71）高于修复即刻（0.76，0.44），差异有统计学意义（P〈0.05）。结论通过严格控制冠延长术适应证和术后修复方法，以及正确牙周护理，前牙牙体缺损达龈下可获得满意的临床修复效果。Objective To carry out surgical crown lengthening for patients with subgingival tooth defect of the anterior teeth crown, discuss the selection of indications, surgical techniques, postoperative repair methods and effects. Meth-ods 36 patients with a total of 41 teeth structure defect were selected from June 2009 to March 2013 in Guang＆#39; anmen Hospital, China Academy of Traditional Chinese Medicine. All of them were treated with anterior subgingival surgical crown lengthening. Patients whose subgingival tooth defect located〈 2 mm, treated with gingival resection; patients whose subgingival tooth defect located 2-4 mm, treated with boneless and bone flap angioplasty. They were given full crown restoration after 6-8 weeks. The repair effects, sulcus bleeding index （SBI）, plaque index （PLI）, loose degrees （TM）, extend the height of the crown, black triangle incidence before and after restoration were compared. Results①There were 41 teeth of defects section exposed, no loose after operation; only 1 case occurred teeth crown off, the rest was good 1 year after restoration.②SBI （0.98, 0.76）, PLI （0.70, 0.44） 6 weeks after surgery, 12 weeks after surgery were lower than before surgery （2.35,1.52）, TM （0.65, 0.52） was higher than before surgery （0.37）, the differences were statistically significant （P〈0.05）.③The height of the prolonged crown 6 weeks after surgery [（3.02±0.51） mm], 12 weeks after surgery [（3.24±0.59） mm] were higher than 2 weeks after surgery [（2.35±0.46） mm], the differences were statisti-cally significant （P〈0.05）.④There were significant differences in the incidence of black triangle among repair imme-diately （78.05%）, 6 months after repair （21.95%）, 12 months after repair （19.51%）, the difference was statistically sig-nificant （P〈 0.05）. ⑤12 months after repair SBI （1.14）, PLI （0.71） were higher than repaired immediately （0.76, 0.44）, the differences were statistically significant （P〈 0.05）.

关 键 词：前牙牙体缺损 冠延长术 修复 

分 类 号：R783.3[医药卫生—口腔医学]