下颌磨牙牙体严重缺损伴Ⅱ度根分叉病变的综合治疗  

Clinical study of the comprehensive treatment of severely damaged mandibular molars with type Ⅱ furcation involvement

作　　者：张梅[1] 邹高峰[1] 常靓 曹桂君 ZHANG Mei;ZOU Gao-feng;CHANG Liang;CAO Gui-jun(Department of Stomatology,Haigang Hospital,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市海港医院口腔科,秦皇岛066000 [2]秦皇岛市第一医院口腔科

出　　处：《北京口腔医学》2021年第1期27-31,共5页Beijing Journal of Stomatology

摘　　要：目的探讨通过浓缩生长因子+引导性组织再生术+植骨术+椅旁计算机辅助设计和制作系统修复下颌磨牙牙体大面积缺损伴Ⅱ度根分叉病变的的临床效果。方法对符合实验条件的40颗下颌磨牙,随机分为实验组(CGF+GBR+植骨术)和对照组(GBR+植骨术),6周复诊行CAD/CAM高嵌体修复。术后6个月,12个月对患牙进行修复体评价(参照USPHS标准)及临床牙周检查。结果术后6个月,12个月时,两组的临床指标与基线时比较均有显著改善(P<0.05),6个月时实验组的垂直附着和水平附着获得均显著高于对照组(P<0.05)。除6个月的牙龈反应(52.5%)和12个月的牙龈反应(72.5%)和颜色反应(97.5%)外,A级率均达到100%。结论CGF可以促进GBR+植骨术在下颌磨牙Ⅱ度根分叉病变治疗中的临床效果,而CGF+GBR+植骨术联合CAD/CAM瓷高嵌体修复严重缺损伴Ⅱ度根分叉病变的下颌磨牙可获得良好的临床效果,但远期效果仍有待观察。Objective To investigate the clinical effect of restoring and preserving the mandibular molars with extensive defect accompanied by typeⅡfurcation involvement by concentrated growth factors(CGF)+guided tissue regeneration(GTR)+bone grafting combined with CAD/CAM porcelain onlays.Methods A total of 40 molars were randomly divided into two groups(n=20).CGF+GTR+bone grafting treatment were applied in the experimental group and GTR+bone grafting treatment was applied in the control group.The molars were repaired six weeks later by CAD/CAM porcelain onlays.The restorations were evaluated 6 months and 12 months after the operation,respectively.Results At 6 months and 12 months after operation,the clinical indexes of the two groups were significantly improved compared with those at baseline(P<0.05).At 6 months,the vertical attachment and horizontal attachment of the experimental group were significantly higher than those of the control group(P<0.05).The rate of Grade A reached 100%except the gingival reaction(52.5%)at 6 months,gingival reaction(72.5%)and color reaction(97.5%)at 12 months.Conclusions CGF combined with GTR+bone grafting improved the clinical effect in the treatment of the mandibular molars with typeⅡfurcation involvement.Restoration by CGF+GTR+bone grafting combined with CAD/CAM porcelain onlay can achieve good clinical results.

关 键 词：高嵌体 下颌磨牙 浓缩生长因子 

分 类 号：R783.3[医药卫生—口腔医学]