应用微创植骨术治疗二壁骨下袋的临床疗效观察  

Clinical efficacy of minimally invasive bone grafting in the treatment of two walled infrabony defect

作　　者：张医军 汪涌[1,2] ZHANG Yijun;WANG Yong(Department of Periodontics,Hefei School of Stomatology,Anhui Medical University,Hefei,Anhui 230031,China;Department of Periodontics,Hefei Stomatological Hospital,Hefei,Anhui 230031,China)

机构地区：[1]安徽医科大学合肥口腔临床学院,安徽合肥230031 [2]合肥市口腔医院牙周科,安徽合肥230031

出　　处：《安徽医药》2020年第4期715-718,I0003,共5页Anhui Medical and Pharmaceutical Journal

基　　金：合肥市第五周期临床重点专科建设项目[合卫科教(2016)256];合肥市自主创新政策“借转补”项目[合卫科教(2017)112]。

摘　　要：目的探讨微创技术应用于牙周植骨术治疗二壁骨下袋的临床效果。方法选取2017年8月至2019年1月36例慢性牙周炎病人,共36颗患牙,采用随机数字表法分成微创技术组18例(18颗牙)与传统术式组18例(18颗牙)。记录各组术后1、3、7 d的疼痛度和基线、术后3个月、术后6个月时的菌斑指数(plaque index,PLI)、探诊深度(probing depth,PD)、临床附着水平(clinical attachment level,CAL)、牙龈退缩量(recession of gingival margin,REC)以及术后3、6个月时两组骨密度(bone mineral density,BMD)的变化。结果两组术后疗效均有改善,微创技术组术后1、3 d的VAS值为(5.11±0.96)分、(2.56±0.51)分,传统术式组的VAS值为(6.56±1.34)分、(3.22±0.88)分,两组间差异有统计学意义(P<0.05);微创技术组与传统术式组比较:术后3个月PD值为(2.17±0.38)mm比(2.61±0.70)mm、CAL值为(4.14±0.70)mm比(4.94±0.62)mm,均差异有统计学意义(P<0.05);术后6个月PD值为(2.28±0.46)mm比(2.67±0.59)mm、CAL值为(4.58±0.69)mm比(5.39±0.61)mm,差异有统计学意义(P<0.05);且术后6个月时BMD值比较,两组间差异有统计学意义(t=3.618,P<0.05)。结论微创技术下牙周植骨术治疗二壁骨下袋比传统术式更有优势。Objective To evaluate the clinical efficacy of minimally invasive technique in the treatment of two walled infrabony de fect with periodontal bone grafting.Methods Thirty six patients with chronic periodontitis treated from August 2017 to January 2019 were chosen.A total of 36 teeth were assigned into minimally invasive technique group and traditional surgery groupaccording to the random number table method.The visual analogue scale(VAS)pain scores were compared 1,3 and 7 days after surgery.Plaque index(PLI),probing depth(PD),clinical attachment level(CAL),and recession of gingival margin(REC)at baseline,3 months and 6 months after surgery and changes in bone mineral density(BMD)at 3 and 6 months after surgery were compared be tween the two groups.Results The postoperative results were improved in both groups.The VAS values of the minimally invasive technique group at 1 and 3 days after surgery were(5.11±0.96),(2.56±0.51),and those of the traditional operation group were(6.56±1.34),(3.22±0.88);the difference between the two groups was statistically significant(P<0.05).By comparison of the mini mally invasive technology group with the traditional operation group,the PD values at 3 months after operation were(2.17±0.38)mm vs.(2.61±0.70)mm,CAL valueswere(4.14±0.70)mm vs.(4.94±0.62)mm,and the differenceswere statistically significant(P<0.05);PD values at 6 months after operation were(2.28±0.46)mm vs.(2.67±0.59)mm,CAL valueswere(4.58±0.69)mm vs.(5.39±0.61)mm,and the differenceswere statistically significant(P<0.05).There was also significant difference in the BMD value at 6 months after operation between the two groups(t=3.618,P<0.05).ConclusionsPeriodontal bone grafting with minimally inva sive techniques is more advantageous than traditional surgery in the treatment of two walled infrabony defect.

关 键 词：慢性牙周炎 牙菌斑指数 牙龈退缩 口腔外科手术 牙周袋 微创技术 牙周植骨术 二壁骨下袋 

分 类 号：R687.3[医药卫生—骨科学]