牙冠延长术改善前牙修复美观效果的临床观察

Clinical evaluation on aesthetic outcome of anterior tooth restoration using crown lengthening surgery

目的探讨对过短前牙行牙冠延长术的手术方法、术后修复时间、适应证及美学效果。方法对22例患者的148颗过短前牙行牙冠延长术后再行修复治疗,用改良 Ryge 标准动态评价牙龈、牙周情况,用 Kay 牙齿美学分类标准评价患牙治疗前后的美观效果。结果牙冠延长术结合修复治疗后,22例患者牙齿的美观效果均达 Kay 牙齿美学分类 ClassⅡ-Ⅰ(化妆)或 ClassⅡ-Ⅰ标准。修复后2周复查时约7.4%患牙的牙龈有较明显的炎症。经治疗及口腔卫生保健指导后,98.6%的患牙在修复6个月以上复查时,牙龈、牙周健康状况良好。2例患者随访4年余,其牙龈、牙周均无炎症表现,牙冠比例保持正常。结论通过正确的适应证选择、准确的修复设计、精细的手术操作、术后足够的牙龈恢复期及正规的口腔卫生保健,牙冠延长术结合修复治疗可获得满意的前牙修复美观效果。

Objective To evaluate methods and clinical performance of crown lengthening surgery for aesthetic restoration improvement of short anterior teeth. Various surgery methods, proper restoration time after surgery, and indications for crown lengthening surgery were discussed. Methods Crown lengthening surgery and prosthetic treatment were applied to 148 short anterior teeth of 22 cases. Modified Ryge criteria were used to assess the gingival health after treatment. Restoration results before and after treatment were evaluated by use of Kay＇s altered dental esthetics classification. Results When patients were re-examined after restoration of two weeks, obvious inflammation was found in 7.40 teeth. After providing the treatment and instruction on oral hygiene, 98.6% gingival health was significantly improved during the follow-up period. Two cases were examined during more than 4-year period and no obvious gingival inflammation and change in dental crown ratio were found. After treatment, all of 22 cases met Kay dental esthetics classification Class Ⅱ-Ⅰ （cosmetic） or Class Ⅱ-Ⅰ criteria. Conclusions Right selection of indications, accurate restoration design, delicate surgery operation, enough recover period for the gingival after surgery, and proper oral hygiene training method, all contribute to the satisfactory aesthetic restoration of anterior teeth.