应用改良E型桥体成形上颌前牙缺牙区软组织形态的临床研究  

Clinical research of application of innovative E-pontic design shaping the soft tissue of missing maxillary anterior teeth

作　　者：黄娜[1,2] 吕杰[1,2] 李平[1,2] 唐尤超[1,2] 王远勤[1,2] 

机构地区：[1]惠州口腔医院 [2]暨南大学医学院附属惠州口腔医院口腔种植科,广东惠州516000

出　　处：《广东牙病防治》2015年第7期358-363,共6页Journal of Dental Prevention and Treatment

基　　金：广东省医学科研基金(A2011681)

摘　　要：目的评价前牙缺失区应用改良E型桥体成形前牙缺牙区软组织形态的临床效果。方法选择上颌前牙缺失拟行天然牙固定义齿修复的患者19例,行天然基牙的牙体预备,不做传统方法的阶段性临时冠牙龈成形。在石膏代型上进行特殊E型桥体的制作,技师要在石膏代型的预计组织进入深度内创造出唇侧90°的线角和邻间角及斜向舌侧的平面。根据该型设计要点和最终修复体的形态在桥体组织面上行激光外科修整,试戴、粘接修复体。修复结束后2个月和12个月进行治疗后随访。测量记录桥体处牙龈乳头高度水平、龈缘水平、角化龈宽度、改良菌斑指数及改良出血指数。结果随访观察期内所有义齿行使功能良好,修复前和修复后12个月时角化龈宽度分别为3.6 mm和2.7 mm。修复后2个月和修复后12个月改良菌斑指数分别为0.70和0.75,改良出血指数分别为0.25和0.40,近中牙龈乳头高度水平分别为5.49 mm和5.31 mm,远中牙龈乳头高度水平为5.89 mm和5.73 mm,龈缘水平为10.84 mm和10.48 mm,改良菌斑指数和改良出血指数的差异均无统计学意义;而牙龈乳头高度水平、龈缘水平,角化龈宽度差异有统计学意义。结论应用改良E型桥体成形上颌前牙缺牙区软组织可获得良好的效果。Objective The purpose of this clinical study was to evaluate the effect of utilizing an innovative E-pontic design in missing maxillary anterior teeth soft tissue area.Methods The patients with the missing anterior teeth who in-tended to receive fixed partial denture restoration were included n this clinical study.At the tooth preparation and impres-sion appointment, the pontic site did not have to be anatomically developed by the provisional at this stage.In the labora-tory setting, the clinician sculpted the approximate outline and predetermined tissue depth on the solid and sectioned mas-ter models.It was important to instruct the ceramist to create 90-degree line angles facially and interproximally when sculpting the model at a predetermined depth.This pontic design had a flat surface on the tissue side of the pontic.The laser gingivectomy began anatomical development at the delivery appointment, then seating the FPD.The width of kera-tinized mucosa were monitored before and 12 month after the final restoration .Modified plaque index, modified bleeding index and gingival papilla height level, gingival margin level were monitored both 2and 12 months after the final restora-tion.Results All the prosthesis were in good function.At the time just before restoration and 12-month recall, the width of keratinized mucosa were 3.6 and 2.7.When 2 and 12 months after the final restoration, we monitored the modi-fied plaque indices were 0.70 and 0.75, the modified bleeding indices were 0.25 and 0.40, the mesial gingival papilla height level were 5.49 mm and 5.31 mm, while the distal gingival papilla height level were 5.89 mm and 5.73 mm, re-spectively, the gingival zenith level were 10.84 mm and 10.48 mm.The modified plaque index, modified bleeding index had no significant difference （P〉0.05）, but the width of keratinized mucosa, gingival papilla height level and the gingi -val margin level had significant difference （P〈0.05）.Conclusion Utilizing the innovative E-pontic design in missing maxillary anterior tee

关 键 词：卵圆形桥体 软组织 牙龈美学 

分 类 号：R783.3[医药卫生—口腔医学]