不同排龈方法在老年人前牙龈下根面龋充填中的临床效果评价

Evaluation of clinical effect of different gingival retraction methods in the filling of anterior subgingival root caries in the elderly

目的探讨不同的排龈方法在老年人前牙龈下根面龋充填治疗过程中的排龈效果及治疗后的临床效果。方法选择150例老年人上前牙颊侧龈下根面龋,窝洞预备后龈壁边缘位于龈下0.8～1mm的患者,随机分为3组,每组50例,充填前采用不同方法排龈。A组采用单线排龈,B组采用排龈膏排龈,C组采用单线排龈加排龈膏,3组均使用自酸蚀粘接剂粘接,3M Z250树脂进行充填。治疗后1年随访,以改良的USPHS直接临床评价系统评估疗效。结果 C组排龈效果优于A组、B组(P<0.05)。1年后C组修复体脱落率低于A组、B组,差异有显著性(P<0.05);边缘适合性、边缘着色、牙龈反应、牙髓反应,C组优于A组、B组,差异有显著性(P<0.05);继发龋和新发缺损方面,3组无差别。结论单线排龈加排龈膏法应用于老年人前牙龈下根面龋充填治疗过程中,能有效分开患牙游离龈,避免窝洞污染,提高临床充填效果。

Objective To investigate the effect of different gingival retraction methods in the filling of the anterior root caries of the elderly patients. Methods A total of 150 aged patients with buccal root caries of maxillary anterior teeth were selected and randomly divided into three groups of 50. The gingival wall of the anterior root cavity was about 0.8-1 mm below the gingiva. Group A used single retraction cord, group B used gingival retraction paste, and group C used both single retraction cord and gingival retraction paste. The cavity was coated with self-etch adhesive (Kelly Phillips) and filled with composite resin (3M Z350) after gingival retraction. Follow-up was performed after one year, and the therapeutic effects of the three groups were evaluated by a modified USPHS direct clinical evaluation system. The data were analyzed by chi-square test. Results The gingival retraction and filling effectiveness of the group C were better than that of the other two groups ( P <0.05). Furthermore, the filling failure, edge coloration, gingival and endodontic irritation of group C were lower than that of the other two groups ( P <0.05). There was no difference among the three groups in secondary caries and new defects. Conclusion The method of gingival retraction paste plus the single retraction cord can avoid cavity pollution by separating the free sputum from the teeth during the filling treatment of anterior subgingival root cavity, and improve the filling effectiveness.