牙龈生物型对树脂修复龈下楔状缺损的临床疗效观察

Clinical effects of gingival biotype on subgingival non-carious cervical lesions

目的评估不同牙龈生物型对复合树脂修复楔状缺损(楔缺)的临床疗效。方法选择颊侧牙颈部边缘位于龈下2 mm内的楔缺患牙,分为薄龈组和厚龈组(n=40),两组排龈后均使用可乐丽菲露自酸蚀粘接剂粘接,3M Z350复合树脂进行充填。治疗后1、2年随访,以改良的USPHS直接临床评价系统和牙龈评价指数进行疗效评估。结果薄龈组和厚龈组患牙修复体固位率、边缘满意度、边缘密合性均在90%以上,但两组间无统计学差异(P>0.05)。厚龈组牙龈指数与薄龈组和修复前相比均偏高,有统计学差异(P<0.05),而薄龈组的牙龈退缩值与厚龈组和修复前相比有统计学意义(P<0.05)。结论在采用有效排龈的前提下,复合树脂修复龈下楔状缺损可取得满意疗效,但薄龈组易发生牙龈退缩,厚龈组易出现牙龈炎症。

Objective To evaluate the clinical effect of different gingival biotype on the treatment of subgingival non-carious cervical lesions. Methods The teeth with wedge-shaped defects at subgingival depth of less 2 mm were selected and divided into thick gingiva group and thin gingiva group(n = 40）. All teeth were restored with the aid of gingival retraction code,then were filled with Clearfil SE Bond system and 3 M Z250 composite resin. All cases were followed up for 1 year and 2 years. The results were evaluated by modified USPHS criteria,gingival index and gingival recession.Results After 1 year and 2 years repairing,more 90% retention rates were recorded in the two groups. There were no significant differences in main indexes,including retention,marginal discoloration and marginal adaptation between the two groups(P〉0. 05）. After 1 year and 2 years repairing,gingival index was increased in thick gingiva group,but gingival marginal recession index was not found in thick gingiva group(P〉0. 05）. Gingival marginal recession index was found in thin gingiva group,but gingival index was not increased in thin gingiva group(P〉0. 05）. Conclusion With the aid of effective gingival retraction methods,subgingival defects can be satisfactorily restored. Gingival marginal recession were more found in thin gingiva group,but gingivitis in thick gingiva group.