牙周基础治疗联合牙周维护治疗重度慢性牙周炎松动前牙的临床研究

Periodontal initial therapy combined with supportive periodontal therapy(SPT) for maintaining mobile teeth in severe periodontitis patients

目的观察重度慢性牙周炎患者Ⅱ度及以上松动前牙经过临床牙周基础治疗及牙周维护治疗后临床转归情况。方法纳入57例重度慢性牙周炎患者,Ⅱ度松动牙118颗,Ⅲ度松动牙23颗。对患者进行牙周基础治疗及牙周维护治疗,分别对患者初诊时(T0)、基础治疗一个月(T1)、基础治疗后2年(T2)不同时间点松动牙齿的探诊深度(probing depth,PD),探诊出血(bleeding of probe,BOP),牙龈出血指数(sulcus bleeding index,SBI)和牙齿松动度(tooth mobility,TM)等临床指标进行记录统计。结果经过牙周基础治疗及牙周维护治疗,所有松动牙齿的临床指标:PD,BOP,SBI,TM,均有明显改善(P<0.05);在2年的观察期内,Ⅱ度松动牙的留存率为95.7%,Ⅲ度松动牙的留存率为39.1%。结论重度慢性牙周炎的重度松动患牙经过系统性牙周治疗后,其相关检查指标均出现改善,95%以上的Ⅱ度松动牙可以得到保留;即使是Ⅲ度松动牙也值得尝试。

Objective To investigate the clinical healing results of loose anterior teeth whose mobility degree is greater thanⅡfollowing periodontal initial therapy combined with supportive periodontal therapy(SPT)of patients with advanced chronic periodontitis.Methods Fifty-seven patients with advanced chronic periodontitis were included,including 118 teeth with loose degreeⅡand 23 teeth with loose degreeⅢ.Every patient received periodontal initial therapy and supportive periodontal therapy(SPT).Clinical healing parameters,including probing pocket depth(PD),bleeding on probing(BOP),sulcus bleeding index(SBI),and tooth mobility(TM),were recorded at baseline(T0),one month(T1)and 2 years(T2)after periodontal initial therapy.Results Significant improvements in clinical parameters(PPD,BOP,SBI and TM)were found for all loose teeth after periodontal initial therapy and supportive periodontal therapy(P<0.05).The percentage of maintenance of teeth in TM2 group was 95.7%and 39.1%in TM2 group after2 years’follow-up.Conclusion Periodontal initial therapy combined with supportive periodontal therapy(SPT)achieves statistically significant clinical improvement in heavily loose teeth of severe periodontitis patients over time.Over 95%of the teeth with loose degreeⅡcan be maintained.Even those teeth with loose degreeⅢare worth trying being maintained.