伴牙槽嵴吸收的牙周炎患者上前牙龈乳头缺陷程度的影响因素分析

Analysis of Influencing Factors on the Degree of Anterior Gingival Papilla Defect in Patients with Periodontitis Accompanied by Alveolar Ridge Resorption

目的分析牙周炎伴牙槽嵴吸收患者上前牙龈乳头缺陷程度的影响因素。方法回顾性选取2020年2月至2023年2月邵武市立医院口腔科收治的牙周炎伴牙槽嵴吸收患者40例(146个上前牙龈乳头),依据缺陷程度方法分为无缺陷组(40个上前牙龈乳头)、轻度缺陷组(52个上前牙龈乳头)、中度缺陷组(28个上前牙龈乳头)、重度缺陷组(26个上前牙龈乳头)4组,每组各10例。统计分析锥形束CT检查结果,分析上前牙龈乳头缺陷程度和锥形束CT检查结果的相关性。结果4组患者的冠状面上从骨嵴顶到邻面CEJ连线距离(Distance from Crest to Adjacent CEJ Line,pCEJ-BC)、对邻接触点到骨嵴顶距离(Distance from Adjacent Contact Point to Crest,CP-BC)、骨嵴顶水平颊舌向骨宽度(Buccal Lingual Bone Width,BCW)均逐渐升高(P<0.05),骨嵴顶水平龈乳头高度(Gingival Papilla Height,PH)逐渐降低(P<0.05),但4组患者的骨嵴顶水平的跟间距(Heel Distance,RD)、临床附着丧失(Clinical Attachment Loss,CAL)之间的差异无统计学意义(P>0.05)。上前牙龈乳头缺陷程度和PH呈显著的负相关关系(P<0.05),和CP-BC、pCEJ-BC、BCW均呈显著的正相关关系(P<0.05)。结论牙周炎伴牙槽嵴吸收患者上前牙龈乳头缺陷程度的影响因素包括CP-BC、pCEJ-BC、BCW、PH,因此在今后的临床工作中应该给予软硬组织增量以充分考虑,必要的情况下调整牙冠外形,从而获得更好的美观效果。

Objective To analyze the influencing factors of the degree of anterior gingival papilla defect in patients with periodontitis withalveolar ridge resorption.Methods A selection was conducted on 40 periodontitis withalveolar ridge resorption patients in the Department of Stomatology of our hospital from February 2020 to February 2023(146 cases of upper anterior teeth gingival papilla).According to the degree of defect,they were divided into four groups:no defect group(40 cases),mild defect group(52 cases),moderate defect group(28 cases),and severe defect group(26 cases),with 10 patientsin each group.The cone-beam CT(CBCT)examination results were statistically analyzed,in order to analyze the correlation between the degree of defects in the upper anterior gingival papilla and the results of cone beam CT examination.Results On the coronal plane,the distance from crest to adjacent CEJ line,(pCEJ-BC),distance from adjacent contact point to crest(CP-BC),and Buccal Lingual Bone Width(BCW)of the four groups were gradually increased(P<0.05),but Gingival Papilla Height(PH)of the four groupsat bone crest level was gradually decreased(P<0.05).However,there were no significant differences in Heel Distance(RD)and Clinical Attachment Loss(CAL)at the bone crest level among the 4 groups(P>0.05).The defection degree of the upper gingival papilla was negatively correlated with PH(P<0.05),and positively correlated with CP-BC,pCEJ-BC,and BCW(P<0.05).Conclusion The influencing factors of the degree of upper anterior gingival papilla defect in patients with periodontitis and alveolar ridge resorption include CP-BC,pCEJ-BC,BCW,and PH.Therefore,in future clinical work,the soft and hard tissue augmentationshould be fully considered,and if necessary,the shape of the dental crown should be adjusted to achieve better aesthetic effects.