二次龈下刮治术和根面平整术与改良威德曼翻瓣术治疗牙周炎的临床疗效  

Clinical efficacy of secondary subgingival scraping and root planningversus modified Widmann flap turning in the treatment of periodontitis

作　　者：董小倩 王海芹 李文璐 周东升[1] 郭鲁燕 DONG Xiaoqian;WANG Haiqin;LI Wenu;ZHOU Dongsheng;GUO Luyan(Department of Stomatology,Heze Municipal Hospital,Heze,Shandong,274000,China)

机构地区：[1]菏泽市立医院口腔科,山东菏泽274700

出　　处：《当代医学》2024年第16期106-109,共4页Contemporary Medicine

摘　　要：目的探讨二次龈下刮治术和根面平整术(scaling and root planing,SRP)与改良威德曼翻瓣术治疗牙周炎的临床疗效。方法选取2019年7月至2022年3月菏泽市立医院口腔科收治的57例慢性牙周炎患者作为研究对象,按照分口设计原则所有患者的同颌对称同名牙随机分为翻瓣组与二次SRP组,其中每组单根牙(前牙48颗,前磨牙9颗)57颗,多根牙(磨牙57颗)57颗,每组114颗牙。两组均行牙周基础治疗,翻瓣组行改良威德曼翻瓣术治疗,二次SRP组行SRP治疗。比较两组单根牙、多根牙治疗前、治疗后6个月探诊深度(probing depth,PD)、牙龈退缩(gingival recession,GR)、临床附着丧失(clinical attachment loss,CAL)、龈沟出血指数(gingival sulcus bleeding index,SBI)、菌斑指数(plaque index,PLI)及牙槽骨吸收情况。结果治疗后,两组单根牙PD均浅于治疗前,CAL均短于治疗前,SBI、PLI均低于治疗前,翻瓣组GR长于治疗前,但二次SRP组GR短于翻瓣组,差异有统计学意义(P<0.05)。治疗后,两组多根牙PD均浅于治疗前,GR、CAL均短于治疗前,SBI、PLI均低于治疗前,但二次SRP组GR短于翻瓣组,差异有统计学意义(P<0.05)。两组单根牙、多根牙术后控制牙槽骨吸收有效率比较差异无统计学意义。结论二次SRP与改良威德曼翻瓣术治疗单根牙和未累及根分叉的多根牙的牙周炎疗效相当,但二次SRP治疗后GR改善更明显,且二次SRP操作相对简单,损伤更小,更易于被患者接受,值得临床推广应用。Objective To investigate the clinical efficacy of secondary subgingival scraping and root planing(SRP)versus modified Widmann flap turning in the treatment of periodontitis.Methods 57 patients with chronic periodontitis admitted to the stomatology department of Heze Munic-ipal Hospital from July 2019 to March 2022 were selected as the study subjects,and in accordance with the principle of split-port design all patients'symmetrical homonymous teeth of the same jaw were randomly divided into the flip-flop group and the secondary SRP group,of which there were 57 single-rooted teeth(48 anterior teeth,and 9 premolars),and 57 multiradial teeth(57 molars)in each group,with 114 teeth in each group.Both groups underwent basic periodontal treatment,the flap group was treated with modified Widmann flap technique,and the secondary SRP group was treated with SRP.The probing depth(PD),gingival recession(GR),clinical attachment loss(CAL),gingival sulcus bleeding index(SBI),plaque in-dex(PLI),and alveolar bone resorption were compared between the two groups for single-rooted and multi-rooted teeth before and 6 months after treatment.Results After treatment,the PD of single-rooted teeth of the two groups was shallower than before treatment,the CAL was shorter than before treatment,the SBI and PLI were lower than before treatment,and the GR in the flip-flop group was longer than before treatment,but the GR in the secondary SRP group was shorter than that in the flip-flop group,and the differences were statistically significant(P<0.05).After treatment,the PD of multi-rooted teeth of the two groups was shallower than before treatment,GR and CAL were shorter than before treatment,and SBI and PLI were lower than before treatment,but GR in the secondary SRP group was shorter than that in the flip-flop group,and the differences were statis-tically significant(P<0.05).There were no statistically significant differences in the comparison of the postoperative control of alveolar bone resorp-tion efficiency between the two groups of single-

关 键 词：改良威德曼翻瓣术 二次龈下刮治术和根面平整术 牙周炎 牙周基础治疗 

分 类 号：R781.42[医药卫生—口腔医学]