植骨联合烤瓷夹板修复末端松动基牙龈下牙周致病菌的分析  

The preliminary analysis of the bacterial effect of main subgingival microbial on bone graft in combination with splint-like PFM bridge

作　　者：王毅[1] 胡杨[2] 杜军[1] 何惠宇[2] 

机构地区：[1]新疆医科大学附属中医医院口腔科,乌鲁木齐830000 [2]新疆医科大学第一附属医院口腔修复科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2016年第7期879-884,共6页Journal of Xinjiang Medical University

基　　金：乌鲁木齐市科学技术计划项目(Y09131002)

摘　　要：目的通过对基牙龈下牙周可疑致病菌进行动态监测及定量分析,探讨在保留KennedyⅢ末端松动基牙后,应用牙周植骨术联合夹板式金属烤瓷冠桥的方法,观察龈下牙周致病菌的变化。方法选取20例伴有牙周病骨缺损的KennedyⅢ末端基牙松动的患者,试验组为10例行植骨术联合夹板式金属烤瓷冠桥修复,对照组为单纯10例行夹板式金属烤瓷冠桥修复。在修复后0、3、6个月行完善的牙周相关检查并收集龈沟液,菌落计数,并采用聚合酶链反应(PCR)法,检测伴放线放线杆菌(Aa)、牙龈卟啉单胞菌(Pg)、中间普氏菌(Pi)、具核梭杆菌(Fn)4种慢性牙周炎相关致病菌。结果试验组与对照组的菌落计数结果差异无统计学意义;与对照组相比,两组间4种牙周可疑致病菌的检出率差异无统计学意义。两组的CAL值、PD基线情况比较无统计学差异;治疗后0、3、6个月植骨组牙周指标结果:CAL、PD在3、6个月均显著下降,而非植骨组牙周指标较前无统计学差异;X线片显示两组病例基牙牙槽骨无进一步吸收,并且植骨组术后牙槽骨量有一定程度增加。结论对于KennedyⅢ牙列缺损末端松动基牙,牙周植骨术联合夹板式金属烤瓷冠桥修复,较单纯的牙周植骨术或夹板式金属烤瓷冠桥的修复方法更利于保持患牙的健康,可获得较满意的近期临床疗效;与试验组与对照组的细菌分析结果相较,同时比较植骨组与非植骨组的临床疗效,发现牙周植骨术联合夹板式烤瓷联冠固定可有效促进牙周骨缺损基牙牙周组织的修复重建。Objective To explore the effect of main subgingival microbial flora in microbial bacteriology aspect by dynamic monitoring and quantitative analysis,before and after the bone graft in combination with splint-like PFM bridge treatment on conserving loosened distal abutment of Kennedy Ⅲ periodontic bone defect.Methods 20 patients with the loosened distal abutment of KennedyⅢ periodontic bone defect were divided into 2groups.10 patients loosened distal teeth were treated by bone graft in combination with splint-like PFM bridge in the treatment group,while the other 10 patients loosened distal teeth were treated with splint-like PFM bridge alone in the control group.Before and after treatment,the fluid of gingival sulous were collected and cultured during 24 hours,4 weeks and 12 weeks.Porphyromonas gingivalis（Pg）,Actinobacillus actinomycetemcomitans（Aa）,Fusobacterium ncleatum（Fn）and Preuotella intermedia（Pi）were detected by PCR.Results The differences of colony count of the four subgingival microbial flora between the treatment group and the control group were not statistically significant;the differences of the base line of the value of PD and CAL between the two groups were also not statistically significant.PD and CAL values were reduced in the treatment group after 3and 6month.X-ray showed that all cases had no further alveolar bone absorption,and the amount of alveolar bone after treatment were increased with certain degree.Conclusion Compared with splint-like PFM bridge alone,the subgingival microbial flora of patients treated with bone graft in combination with splint-like PFM bridge were declined obviously.In comparison of bacterial analysis between treatment group and control group,we found that bone graft in combination with splint-like PFM bridge could promote the reconstruction of periodontal tissue of loosened distal teeth.

关 键 词：夹板式固定桥修复 牙周植骨术 牙周可疑致病菌 

分 类 号：R78[医药卫生—口腔医学]