牙冠延长术在残根残冠修复中的临床疗效

Clinical evaluation of restoring residual root and crown with crown lengthening surgery

目的评价牙冠延长术在牙体缺损达龈下的残根残冠修复中的临床疗效。方法自2004年5月至2005年6月,对32例患者的36颗牙体缺损达龈下的患牙,术前按断端位于龈下最深距离分为A组(20颗患牙,距离<3.0mm)和B组(16颗患牙,3.0mm≤距离≤4.0mm),均采用牙冠延长术暴露龈下牙体断面,术后6周行桩冠修复。分别记录和比较手术前、后牙周探诊深度(PD)、菌斑指数(PLI)、龈沟出血指数(SBI)和牙齿松动度,以观察临床疗效。结果术后随访患者6个月,两组病例术后6周牙体断端均暴露较好、龈缘颜色正常,术后修复效果有效率为100%,满意率为77.78%。A组术后无松动,修复效果满意;B组术后50.00%出现Ⅰ度松动,修复效果欠佳,两组修复效果比较差异有显著意义(P<0.05)。术后各阶段两组的PD、PLI、SBI均明显优于术前(P<0.05),但两组术后牙周指数比较差异无显著意义(P>0.05)。结论牙冠延长术有利于残根残冠的保存和修复,但要注意适应证的选择。

Objective To evaluate the clinical effect of the crown lengthening surgery on the restoration of residual root and crown with subgingivally involved defect. Methods From May 2004 to June 2005, according to the subgingival depth of the defect. 36 teeth from 32 patients with subgingivally involved defect were diveded into two groups： group A（20 teeth, depth〈 3.0 mm）, group B （16 teeth, 3.0 mm≤depth≤4.0 mm）. All teeth were treated by the crown lengthening first and then underwent post - crown prosthesis at 6 weeks postoperatively. After fowllowing up for 6 months the preoperative and postoperative date were reviewed and analyzed. Results The teeth sections of two groups were exposed well and the color of the gingival margin of two group looked normal. The overall effective rate was 100 96 and satiafying rate was 77.78 %. The restoration of group A without any teeth loose was better than that of group B with 50.00 96 teeth loose at degree Ⅰ.Postoperative PD, PLI and SBI were better than those preopera- tively （P〈0.05）. There were no differences on the periodontal index among the two groups （P 〉0.05）. Conclusion Crown lenthening surgery is a good method for the protection and restoration of residual root and crown, but should be limited to the right patients.