夹板式黏结桥修复牙周炎伴牙列缺损的临床效果

Clinical effect of splinted fixed prostheses on restoration of periodontitis combined with denture defect

目的探讨夹板式黏结桥修复中、重度牙周炎伴牙列缺损的临床效果。方法 26例经牙周综合治疗病情稳定的中、重度牙周炎患者,进行夹板式黏结桥修复,共制作修复体31件,比较分析患者修复前及修复后6个月、1年、2年时基牙的牙周探诊深度(PD)、龈沟出血指数(SBI)和牙齿松动度(TM);拍摄X线片检查牙槽骨高度、形态及其致密度、牙周膜宽度等情况;结合患者的使用情况,评定疗效。结果患者修复后6个月、1年、2年的PD逐渐变浅,均显著低于修复前(P值均<0.05)。患者修复前及修复后6个月、1年、2年的SBI的差异均无统计学有意义(P值均>0.05)。修复后所有松动牙的TM均得到改善,黏结基牙未出现TM增加;随着修复时间的延长,出现个别黏结桥基牙组整体TM增加,修复后与修复前比较,Ⅰ度TM所占比例均显著升高(P值均<0.01),但修复后不同时间Ⅰ度TM所占比例的差异均无统计学意义(P值均>0.05)。X线片显示,修复后基牙的牙周膜和硬骨板清晰完整,牙槽骨高度未见明显降低,骨密度增加。结论夹板式黏结桥能有效固定中、重度牙周炎患者的松动牙,修复伴有的牙列缺损,具有良好的临床效果。

Objective To evaluate the clinical effect of splinted fixed prostheses on moderate to severe periodontitis with defect of dentition.Methods After comprehensive periodontal treatment and achievement of stable condition,31 splinted fixed prostheses were made in 26 patients with moderate to severe periodontitis.The periodontal probing depth（PD）,sulcular bleeding index（SBI） and tooth mobility（TM） were compared before treatment,and 6,12,and 24 months after treatment.The height,shape and density of alveolar bone and the width of periodontal membrane were measured by X ray.The clinical effects were evaluated by the above parameters and the application of prothesis in patients.Results PD gradually decreased 6,12,and 24 months after treatment,and the difference between pretreatment and post-treatment had statistical significance（all P0.05）.The difference in SBI between pretreatment and 6,12,and 24 months after treatment had no statistical significance（all P0.05）.TM improved in all loose teeth after splint fixation,and was not aggravated in abutment teeth.With time going,TM increased in several abutment teeth,but TM in gradeⅠwas significantly increased after splint fixation（all P0.05）.The difference of TM in gradeⅠat different time points after splint fixation had no statistic significance（all P0.05）.X-ray showed clear images of laminadura and periodontal ligament,stable height of alveolar bone and increased bone density.Conclusion Splinted fixed prostheses can effectively fix loose teeth in the patients with moderate and severe periodontitis and restore defect of dentition.