排龈线结合推龈器排龈修复龈下楔状缺损的临床疗效

The clinical effect of gingival retraction cord combines gingival retractor in the restoration of sub-gingival wedge-shaped defect

目的评估排龈线结合推龈器排龈修复龈下楔状缺损的临床疗效。方法选择缺损边缘位于龈下1~2 mm楔状缺损牙齿240颗随机分为排龈线组、推龈器组和联合组,各80颗。排龈线组使用排龈线排龈,推龈器组使用推龈器排龈,联合组使用排龈线结合推龈器排龈。各组均使用可乐丽菲露自酸蚀粘结剂粘结,可乐丽菲露AP-XTM树脂进行充填。治疗后1年随访,追踪观察3组充填材料脱落情况和牙龈健康状况。结果联合组1年后充填材料脱落4颗,充填材料保存完好的76颗患牙中有3颗发生牙龈炎,充填材料脱落率和龈炎发生率分别为5.00%、3.95%。排龈线组1年后充填材料脱落12颗,充填材料保存完好的68颗患牙中有9颗发生牙龈炎,脱落率和龈炎发生率分别为15.00%、13.24%。推龈器组1年后充填材料脱落15颗,充填材料保存完好的65颗患牙中有11颗发生牙龈炎,脱落率和龈炎发生率分别为18.75%、16.92%。联合组的脱落率和龈炎发生率比排龈线组及推龈器组低,差异有统计学意义(P<0.05)。结论龈下楔状缺损修复中应用排龈线结合推龈器排龈能有效提高临床治疗效果。

Objectives To evaluate the clinical effect on prosthesis of sub gingival wedge-shaped defect with gingival retraction cord and gingival retractor. Methods 240 teeth with wedge-shaped defect in sub-gingival depth of 1-2mm were randomized into gingival retraction cord group,gingival retractor group and combined group with 80 teeth in each group. CLEARFIL SE BOND system and CLEARFIL AP-XTMcomposite resin were used in each group to bond and fill the defects. Follow-up study was carried out 1 year after treatment to examine the filling material loss and gingival health status. Results In the combined group,filling material in 4 teeth fell off,and 3teeth of the 76 teeth whose filling material was in good condition got gingivitis. The loss rate of the filling material and the incidence of gingivitis in the combined group were 5. 00% and 3. 95%. In the gingival retraction cord group,filling material in 12 teeth fell off,and9 teeth of the 68 teeth whose filling material was in good condition got gingivitis. The loss rate of the filling material and the incidence of gingivitis in the combined group were 15. 00% and 13. 24%. In the gingival retractor group,filling material in 15 teeth fell off,and 11teeth of the 65 teeth whose filling material was in good condition got gingivitis. The loss rate of the filling material and the incidence of gingivitis in the combined group were 18. 75% 、16. 92%. The loss rate of the filling material and the incidence of gingivitis in the combined group were lower than those of gingival retraction cord group and gingival retractor group,and there is a statistical significance in difference( P < 0. 05). Conclusions Utilization of gingival retraction cord combined with gingival retractor in the restoration of subgingival wedge-shaped defect can efficiently improve the overall quality of the restoration.