牙冠延长术修复龈下牙体缺损的疗效评价

Evaluation of the clinical effect of restoring of the teeth with subgingivally involved defect conserved by 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。方法对大连大学附属中山医院口腔科2004年12月至2007年11月收治的48例患者52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浅缺损组(28颗患牙,距离<2.5mm)和深缺损组(24颗患牙,2.5mm≤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,观察临床疗效。结果两组病例术后6周牙体断端均暴露较好、龈缘颜色正常。术后6个月修复满意率为80.77%。浅缺损组术后无松动,修复效果满意。深缺损组术后半数出现I度松动,修复效果欠佳,两组修复效果比较差异有统计学意义(P<0.05)。术后各阶段两组的PD、PLI、SBI均明显优于术前(P>0.05)。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 2007,according to the subgingival depth of the defect,52 teeth from 48 patients with subgingivally involved defect were divided into two groups:minor defect group(28 teeth,depth <2.5 mm),major defect group(24 teeth,2.5 mm≤depth≤4.0 mm).All teeth were treated by the crown lengthening first and then underwent postcrown prosthesis at 6 weeks postoperatively.After following up for 6 months the preparative and postoperative data were reviewed and analyzed.Results The teeth sections of two groups were exposed well and the color of the gingival margin of two groups looked normal.The overall satisfying rate was 80.77%.The restoration of minor defect group without any teeth loose was better than that of major defect group with half teeth loose at degree I.Postoperative PD,PLI and SBI were better than those before operation.(P<0.05).There were no differences on the periodontal index among the two groups(P>0.05).Conclusion Crown lengthening surgery is a good method for the protection and restoration of residual root and crown,but should be used properly.