微创牙冠延长术的临床疗效评价  

The clinical effect of minimally invasive crown lengthening

作　　者：汪涌[1] 陈莹[1] 姚莉莉[2] 

机构地区：[1]合肥市口腔医院牙周黏膜科,安徽合肥230001 [2]合肥市口腔医院牙体牙髓一科,安徽合肥230001

出　　处：《临床口腔医学杂志》2016年第8期472-475,共4页Journal of Clinical Stomatology

基　　金：2014年合肥市自主创新政策"借转补"项目;安徽省2015年公益性技术应用研究联动计划项目(1501ld04067);合肥市第四周期医学重点学科建设计划资助卫科([2013]237号)

摘　　要：目的：评价微创技术应用于牙冠延长术的临床效果。方法：将39例患者的45颗冠缺损达龈下最深位点1．5～4 mm患牙进行随机分组。对照组24颗患牙施行常规牙冠延长术；实验组21颗患牙是将微创技术应用于牙冠延长手术：术者头戴放大镜，翻瓣时采用显微牙周手术器械，去骨时采用超声骨刀，缝合时采用5-0不可吸收缝线。分别记录术前、术后1周（拆线）、术后8周（修复前）以及修复完成后6个月缺损最深位点处的探诊深度（ PD）、龈沟出血指数（ SBI）和松动度（ MD），以及修复后6个月牙龈退缩（ GR）率，并记录术后不良反应情况。结果：①两组患牙治疗后SBI、PD指标较术前有明显改善（P＜0．01）；术后1周MD较术前有加大趋势（P＜0．01），但到修复前和修复后6个月又趋于稳定（P＞0．05）。②术后1周实验组SBI和PD指标的改善优于对照组，两组间的差异有统计学意义（P＜0．01）；修复前和修复后6个月实验组PD指标的改善优于对照组，两组间的差异有统计学意义（P＜0．01），SBI指标的改善也优于对照组（P＜0．05）。③修复后6个月实验组均无牙龈退缩，对照组有6例出现0．5-1．0 mm的牙龈退缩，两组相比P＜0．05。④对照组有4例出现术后肿胀，3例术后出现疼痛；实验组均无术后肿胀、疼痛等并发症。结论：微创技术应用于牙冠延长术能够明显改善临床指标，降低术后不良反应以及术后牙龈退缩，获得更好的临床疗效。Objective：The goal of this investigation was to evaluate the clinical effect of minimally inva-sive technique in crown lengthening.Method：Thirty-nine patients with 45 teeth defects 1.5-4 mm below gingiva were randomly divided into two groups.The crowns were lengthened with traditional method in control groud（22 patients with 24 teeth）,and experimental group（17 patients with 21 teeth） used minimally invasive technique：surgery was performed with the aid of an operating microscope and microsurgical instrument, the crown were lengthened with piezosurgery,5-0 stitches in suture.Probing depth（ PD） ,sulcus bleeding index（ SBI） and mobili-ty degree（ MD） were measured before surgery and one week,8 weeks after surgery,and 6 months after prosthodon-tic.Gingival recession（ GR） was measured at 6 months after prosthodontic treatment,and recorded the postopera-tive adverse reactions.Results：SBI,PD at one week after surgery in two groups were obviously improved which compared with presurgical（P〈0.01）,Experimental group improve significantly to the control group（P〈0.05）, but MD were increased（P〈0.01）,while at 8 weeks postsurgery and 6 months after prosthodontic were not statis-tically different with two groups（ P〉0.05） .At 1 week after surgery experimental group the SBI and PD is better than that of control group,the differences between two groups was statistically significant（P〈0.01）.At 8 weeks postsurgery and 6 months after prosthodontic treatment PD in experimental group is lower than control group（P〈0.01）,the improvement of SBI is superior to the control group（P〈0.05）.GR was observed in 6 teeth of control group 6 month after prosthodontic,and there are 4 cases with postoperative swelling and 3 cases with postoperative pain in control group,but not observed in experimental group（P〈0.05）Conclusion：Minimally invasive technol-ogy in crowns lengthening can obviously improve the clinical indicators, reduce postoperative adverse reactions and gingival

关 键 词：微创技术 牙冠延长术 超声骨刀 

分 类 号：R782.1[医药卫生—口腔医学]