Superbond粘结系统固定牙周炎松动前牙2年的临床观察

2-year clinical evaluation of Superbond bounding system for the treatment of mobile anterior teeth with periodontitis

目的观察Superbond粘结系统固定牙周炎松动前牙2年的临床效果。方法选取49例因牙周炎导致前牙松动的患者作为研究对象,所有患者消除咬合创伤后采用Superbond粘结系统作为牙周夹板行松牙固定治疗。分别于固定后3、6、9、12、18、24个月进行复诊,记录牙周夹板断裂率和牙槽骨的变化情况,比较不同时间段菌斑指数(PLI)、牙龈指数(GI)、牙周探诊深度(PD)、附着丧失(AL)的变化及切割功能、美观性与舒适度,并评价临床疗效。结果固定后所有患者的松动牙均变得稳固,咀嚼效率明显改善。牙周夹板在3~6个月期间有3例患者出现断裂,每例患者1个位点出现断裂,断裂率为6.1%。固定后3个月PD低于固定前,固定后12个月PD低于固定后3个月,差异有统计学意义(P<0.05);固定后12、18、24个月AL与固定前及固定后3个月比较,差异有统计学意义(P<0.05)。固定后3、6个月,所有患者治疗有效率均为100.0%;固定后9个月,治疗有效率为98.0%,固定后24个月的治疗有效率为89.8%,因5例患者发生牙周炎症加重,治疗失败。固定后3、6、9、12、18、24个月切割功能评分高于固定前,差异有统计学意义(P<0.05);固定后6、9、12、18、24个月舒适度评分明显高于固定前,差异有统计学意义(P<0.05)。87.8%的患者牙槽骨骨小梁密度增加,骨白线出现,部分牙位有少量牙槽骨再生。结论通过2年的观察,采用Superbond粘结系统固定因牙周炎松动的前牙获得了稳定可靠的疗效,且有助于牙周状况的改善,能够在不影响患者美观和舒适度的前提下提高患者的咀嚼功能。

Objective To observe the 2-year clinical effect of Superbond bounding system for the treatment of mobile anterior teeth with periodontitis.Methods There were 49 patients with mobile anterior teeth due to periodontitis as study subjects,and all patients were treated with superbond bonding system as periodontal splint after occlusal trauma was eliminated.The patients were followed up 3,6,9,12,18 and 24 months after splinting.The fracture rate of periodontal splint and changes of alveolar bone was recorded.The changes of plaque index(PLI),gingival index(GI),periodontal probing depth(PD),attachment loss(AL),cutting function,aesthetics and comfort at different time points was compared,and the clinical efficacy was evaluation.Results After splinting,the loose teeth of all patients became stable and masticatory efficiency was significantly improved.There were 3 cases of periodontal splint fracture during 3-6 months,and 1 site of each patient was broken,with fracture rate as 6.1%.PD 3 months after splinting was lower than that before splinting,and PD 12 months after splinting was lower than that 3 month after splinting,and the difference was statistically significant(P<0.05).There were statistically significant differences in AL at 12,18 and 24 months after splinting compared with those before and 3 months after splinting(P<0.05).3 and 6 months after splinting,the effective rate of all patients was 100.0%;9 months after splinting,the effective rate was 98.0%.Because of the aggravation of periodontal inflammation in 5 patients,the treatment failed,and the effective rate of 24 months after splinting was 89.8%.The score of cutting function at 3,6,9,12,18,24 months after splinting was higher than that before splinting,and the difference was statistically significant(P<0.05).The comfort score at 6,9,12,18,24 months after splinting was higher than that before splinting,and the difference was statistically significant(P<0.05).87.8%of the patients had increased trabecular bone density,white line appeared,and a small amount of alveolar bone regeneration was found in some teeth.Conclusion After 2 years of observation,the Superbond bonding system shows stable and reliable efficacy on mobile anterior teeth with periodontitis,and it was helpful to improve the periodontal condition and improve the masticatory function without affecting the aesthetics and comfort of patients.