三种不同排龈方法在固定义齿修复中的应用比较

Comparison of the application of three different gingival retraction methods in fixed prothese

目的:探讨在固定义齿修复时,不同牙龈生物型应用单线法、双线法和排龈膏排龈的临床效果。方法:选择固定义齿单冠修复共268例,薄龈生物型为129例,厚龈生物型为139例,各组内样本随机划分为A、B、C三组,分别采用单线法、双线法和排龈膏排龈,橡胶取模并灌注石膏模型。治疗后评价疼痛程度、排龈效果,并测定牙龈指数(GI)。结果:薄龈生物型C组与A、B两组的疼痛程度、牙龈出血的发生率的差异具有显著性(P <0. 05),排龈效果的差异没有显著性(P> 0. 05);厚龈生物型中B、C两组与A组在排龈效果上差异有显著(P <0. 05),疼痛程度和牙龈出血发生率的差异没有显著性(P> 0. 05)。结论:固定义齿修复时,薄龈生物型优先选择排龈膏排龈,以减少疼痛和牙龈出血的发生率,增加临床舒适度;厚龈生物型则选择排龈膏和双线法排龈,以获取精细印模和模型。

Objective： To analyze the clinical effects of single-cord, double-cord, and paste retraction in different kinds of gingival biotype during fixed prothese. Methods： 268 cases of single crown protheses were included, with 129 cases being thin gingival biotype and 139 cases thick gingival biotype. The thin and thick gingival biotype participants were separately and randomly assigned to three groups （Group A, B and C）, which received single-cord, double-cord and paste retraction, respectively, and then rubber impression and plaster model were made. The degree of pain and gingival retraction outcomes were evaluated and gingival index （GI） was measured after treatment. Results： Significant difference in the degree of pain and incidence of gingival bleeding was found between Group C and the other two groups（Group A and B） among the thin gingival biotype participants （P〈0.05）, while there was no significant difference in gingival retraction outcomes （P〉0.05）. As regarding the thick gingival biotype participants, the gingival retraction outcomes were found significantly different between Group A and the other two groups （Group B and C） （P〈0.05）, while the degree of pain and rate of gingival bleeding were not significantly different （P〉0.05）. Conclusion： During fixed prothese, paste retraction is the optimal choice for the thin gingival biotypes to reduce the degree of pain and incidence of gingival bleeding and increase the sense of clinical comfort, while people with thick gingival biotype are suggested to undergo paste or double-cord retraction to make finer rubber impression and plaster model.