生物导向性牙体预备技术修复外伤前牙缺损2例报道及文献回顾  

Application of a biologically oriented preparation technique in the restoration of traumatic anterior tooth defects:two cases report and literatures review

作　　者：刘璐璐 史佳帆 孙铭泽 娄岸 龚伶玲 李明[1,2] LIU Lulu;SHI Jiafan;SUN Mingze;LOU An;GONG Lingling;LI Ming(School of Stomatology,Hunan University of Chinese Medicine,Changsha 410208,China;Changsha Stomatological Hospital,Changsha 410004,China)

机构地区：[1]湖南中医药大学口腔医(学)院,湖南长沙410208 [2]长沙市口腔医院,湖南长沙410004

出　　处：《口腔疾病防治》2025年第2期145-152,共8页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：湖南省自然科学基金面上基金项目(2022JJ30630);湖南省教育厅重点项目(22A0249);湖南省科技厅医卫行业联合基金项目(2024JJ9519);长沙市自然科学基金(kq2208458);湖南省自然科学基金医卫行业联合基金(2024JJ9534)。

摘　　要：目的 探讨生物导向性预备技术(biologically oriented preparation technique,BOPT)在美学区外伤牙修复中的应用效果,为临床提供参考。方法 本研究获得患者知情同意。报道2例应用BOPT技术修复美学区外伤后牙体组织缺损达龈下的外伤牙病例。2例病例均因右上前牙外伤致缺损1个月余前来就诊。通过口内检查及美学分析发现。病例1,男,67岁。患者诉右上前牙一个月前因外伤致缺损露髓,于牙体牙髓科行根管治疗术,术后无不适,因影响咀嚼和美观,要求修复。口内检查:11残根,唇侧断端最深处呈V字型,位于龈下2 mm,近远中断端位于龈下1~2 mm,腭侧断端位于龈上2~3 mm,剩余牙体组织少,根管口可见充填物,近远中径小,牙根偏腭侧,叩(-),未见明显松动度,11近远中龈乳头缺如;21牙冠近中倾斜;厚龈生物型;牙石(+),探诊深度(probing depth,PD):2~4 mm;附着丧失(attachment loss,AL):1~2 mm;牙龈退缩(gingival recession,GR):0~1 mm;出血指数(bleeding index,BI):1~2,诊断:11残根;慢性牙周炎。病例2,男,34岁。患者诉右上前牙1个月前因外伤致缺损露髓,于牙体牙髓科行根管治疗术,术后无不适,因影响咀嚼和美观,要求修复。口内检查:12、13大面积缺损,唇侧壁缺损达龈下约1 mm,断端可见充填物,近远中断端位于龈上约2~4 mm,腭侧断端位于龈上约3~4 mm,叩(-),未见明显松动度,唇侧牙龈稍红肿;厚龈生物型;牙石(++~+++);PD:3~5 mm;AL:1~3 mm;GR:0~2mm;BI:2~3,诊断:12、13牙体缺损;慢性牙周炎。治疗方案:2例病例均拟进行牙周基础治疗后,应用BOPT技术,行垂直型牙体预备,通过临时修复体塑形软组织,选用高透单一氧化锆全瓷冠,结合计算机辅助设计/计算机辅助制造(computer aided design/computer aided manufacturing,CAD/CAM)技术精准复制临时修复体的穿龈轮廓,从而重建红白美学。结果 BOPT技术实现了美学区外伤牙牙体缺损的修复以及软组织塑形。病例1,治疗前Objective To evaluate the effectiveness of the biologically oriented preparation technique(BOPT)in re-storing traumatic tooth defects within the aesthetic zone,serving as a clinical reference.Methods This study has been re-viewed and approved by the Ethics Committee,and informed consent has been obtained from patients.Two cases are de-tailed,involving traumatic tooth defects under the gingival level,repaired using BOPT in the aesthetic region.Both individ-uals reported defects resulting from trauma to the upper right anterior teeth occurring over a month prior.Case 1:male,67 years old.The patient complained of a defect and exposed pulp in the right upper front tooth caused by trauma one month ago.Root canal treatment was performed in the dental pulp department,but there was no discomfort after the surgery.Due to the impact on chewing and aesthetics,restoration is required.Oral examination:11 residual roots,the deepest part of the lip side fracture,in a V-shape,located 2 mm subgingival,1-2 mm subgingival near and far,and 2-3 mm supragingival on the palatal side fracture.There is little remaining dental tissue,and filling material can be seen at the root canal opening.The proximal and distal diameters are small,and the tooth root is tilted towards the palatal side.After tapping(-),no obvi-ous looseness is observed.11 missing gingival papilla near and far;21 dental crowns tilted towards the middle;thick gingi-val biotype;dental calculus(+),probing depth(PD):2-4 mm;Attachment loss(AL):1-2 mm;Gingival recession(GR):0-1 mm;bleeding index(BI):1-2,diagnosis:11 residual roots;chronic periodontitis.Case 2,male,34 years old.The patient com-plained of a defect and exposed pulp in the right upper front tooth caused by trauma one month ago.Root canal treatment was performed in the dental pulp department,but there was no discomfort after the surgery.Due to the impact on chewing and aesthetics,restoration is required.Oral examination:Large area defects were found in sections 12 and 13,with the lip side wall defect reaching about

关 键 词：生物导向性牙体预备 牙体缺损 外伤牙 垂直型牙体预备 无肩台牙体预备 牙龈塑形 美学修复 

分 类 号：R78[医药卫生—口腔医学]