隧道成形术治疗磨牙Ⅲ度根分叉病变临床疗效观察

Clinical Evaluation of Tunneling Procedure in Treatment of Class Ⅲ Furcation Involvement in Mandibular First Molars

目的探讨隧道成形术治疗磨牙Ⅲ度根分叉病变的疗效。方法从已做牙周基础治疗1月的患者中,选择患有下颌第一磨牙Ⅲ度根分叉病变的慢性牙周炎患者34例共34颗患牙,随机分为对照组和实验组,对对照组患牙做基础治疗,对实验组患牙做隧道成形术,记录术前、术后3月和术后6月的临床指标包括探诊深度(PD)、附着丧失(AL)和出血指数(BI),进行统计学分析。结果术后3月和6月复查发现:实验组和对照组PD均较术前减少,差异有统计学意义(P<0.01)。并且实验组PD减少量较对照组PD减少量大,差异有统计学意义(P<0.01)。术后3月和6月,实验组与对照组BI均较术前减少,差异有统计学意义(P<0.01)。实验组6月BI与3月BI值相比,进一步减少,差异仍有统计学意义(P<0.01),而对照组减少量无统计学意义(P>0.05)。术后3月和6月,实验组与对照组AL均较术前减少,差异无统计学意义(P>0.05),且两组之间比较差异也无统计学意义(P>0.05)。结论隧道成形术治疗下颌第一磨牙Ⅲ度根分叉病变疗效满意。

Objective To evaluate the clinical results of tunneling procedure in the treatment of class Ⅲ furcation involvement in mandibular first molars.Methods 34 mandibular first molars with class Ⅲ furcation involve-ments from 34 systemically healthy patients with chronic periodontitis having accepted subgingival scaling and root planning one month ago were selected.They were randomly divided into two groups.In the experimental group,tunneling procedures were applied on the furcations.In the control group,subgingival scaling and root planning were performed on the furcations.Clinical parameters including probing depth（PD）,attachment lossing（AL）and bleeding index（BI）were recorded at baseline,3-month postoperativel,and 6-month postoperativel respectively.Results At 3-month and 6-month clinical examination,in the experimental group,the mean PD reduced.There was statisticaly significant reduction compared with at baseline and control group（P〈0.01）.The mean BI reduced.There was statistically significant reduction compared with at baseline（P〈0.01）.At 6-month clinical examination,in the experimental group,the mean BI Continued to reduce.There was still statistically significant reduction compared with at 6-month clinical examination（P〈0.01）.A decrease of AL was also observed in the experimental group,but there was no significant difference among baseline,3-month postoperatively and 6-month postoperatively（P〉0.05）.Conclusion These short-term results from the study showed the satisfactory effects of tunneling procedure in the treatment of degree Ⅲ furcation involvements in the mandibular first molars.