超声骨刀在厚龈生物型前牙冠延长术中的应用

Clinical evaluation of piezosurgery in crown lengthening of anterior teeth with thick gingival biotype

目的：评价超声骨刀行牙冠延长术对保留牙体缺损位于龈下3mm以内、厚龈生物型前牙的临床疗效。方法：纳入厚龈生物型前牙肩台、龋坏或折裂位点位于龈下3mm以内的患者20例。行必要的牙周基础治疗和根管治疗后随机分为两组，实验组10例29个患牙，采用超声骨刀去骨行冠延长术；对照组10例34个患牙，采用高速涡轮手机去骨行冠延长术。测量术前和术后4、8周、6月龈沟出血指数（SBI）、菌斑指数（PLI）及术后6月牙龈退缩率，并记录手术所需时间。结果：术后4、8周，实验组SBI和PLI均低于对照组（P〈0．05），6月时两组SBI和PLI无显著差异（P〉0．05）；术后6月实验组均无牙龈退缩，对照组7个牙有0．5-1．0mm的牙龈退缩，两组相比P〈0．05；实验组平均手术时间多于对照组（P〈0．05）。结论：采用超声骨刀行牙冠延长术对保留牙体缺损位于龈下3mm内的厚龈生物型前牙，具有比传统方法更好的临床疗效。

AIM： To evaluate the clinical effect of piezosurgery in crown lengthening of anterior teeth with thick gingival biotype. METItODS： 20 patients with 63 anterior tooth defects 3 mm below gingiva and with thick gingival biotype were ineluded. After periodontal non - surgical treatment and root canal therapy, the patients were randomly divided into 2 groups. The crowns were lengthened with piezosurgery in experimental group （ 10 patients with 29 teeth） and high - speed air turbine in control group（ 10 patients with 34 teeth） respectively. Surgery duration was recorded. Sulcus bleeding index （SBIi and plaque index （PLI） were measured before surgery and 4weaks, 8 and 6 months after surgery. Gingival recession （GR） was measured at 6 months after surgery. RESULTS： Duration of surgery （min/tooth） in experimental and control group was 17.0 ± 1.87 and 9.90 ±1.53 respectively（ P 〈 0.05 ）. SBI and PLI at 4 and 8 week after surgery in piezosurgery group were lower than those in control group （ P 〈 0.05 ）, while at 6 month after surgery were not statistically different between groups （ P 〉 0.05 ）. GR was observed in 7 teeth of control group 6 month after surgery , but not observed in experimental group （ P 〈 0.05 ）. CONCLUSION： Piezosurgery is more effective than high-speed air turbine in the treatment of anterior teeth with thick gingival biotype.