CAJ | 학술논문

目的：比较牙周翻瓣术与二次龈下刮治和根面平整术（scaling and root planing ，SRP）治疗慢性牙周炎的临床疗效。方法选取牙周基础治疗6 w后牙周探诊深度为5～7 m m的单根牙117颗作为研究对象，同一患者的左右两侧牙随机分为二次SRP组和改良Widman翻瓣组。二次SRP组患者在局麻下对纳入的患牙用赛特力超声治疗机和Gracey刮治器进行龈下刮治和根面平整术，翻瓣组患者在局麻下行改良Widman翻瓣术。治疗后3、6个月对两组患者进行复诊，并对患者的受试牙进行牙周专业检查，记录探诊出血（BOP）、探诊深度（PD）、临床附着水平（CAL ）及牙龈退缩（GR）。结果二次SRP组和改良Widman翻瓣组治疗后6个月患牙的BOP阳性率、PD、CAL、GR分别为16．92％、（2．82±0．74） mm、（5．05±1．02） mm、（2．02±0．60） mm和11．60％、（2．54±0．49） mm、（4．90±0．83） mm、（2．35±0．67） mm ，两组治疗后6个月各项指标与治疗前比较差异均有统计学意义（P ＜0．05）。治疗后6个月两组间BOP阳性率、PD及CAL 比较差异无统计学意义（P＞0．05），但改良Widman翻瓣组GR明显高于二次SRP组（P＜0．05）。结论对于单根牙，二次SRP和改良Widman翻瓣术可达到相同的治疗效果，但翻瓣术后的牙龈退缩较二次SRP明显。
목적：비교아주번판술여이차간하괄치화근면평정술（scaling and root planing ，SRP）치료만성아주염적림상료효。방법선취아주기출치료6 w후아주탐진심도위5～7 m m적단근아117과작위연구대상，동일환자적좌우량측아수궤분위이차SRP조화개량Widman번판조。이차SRP조환자재국마하대납입적환아용새특력초성치료궤화Gracey괄치기진행간하괄치화근면평정술，번판조환자재국마하행개량Widman번판술。치료후3、6개월대량조환자진행복진，병대환자적수시아진행아주전업검사，기록탐진출혈（BOP）、탐진심도（PD）、림상부착수평（CAL ）급아간퇴축（GR）。결과이차SRP조화개량Widman번판조치료후6개월환아적BOP양성솔、PD、CAL、GR분별위16．92％、（2．82±0．74） mm、（5．05±1．02） mm、（2．02±0．60） mm화11．60％、（2．54±0．49） mm、（4．90±0．83） mm、（2．35±0．67） mm ，량조치료후6개월각항지표여치료전비교차이균유통계학의의（P ＜0．05）。치료후6개월량조간BOP양성솔、PD급CAL 비교차이무통계학의의（P＞0．05），단개량Widman번판조GR명현고우이차SRP조（P＜0．05）。결론대우단근아，이차SRP화개량Widman번판술가체도상동적치료효과，단번판술후적아간퇴축교이차SRP명현。
Objective To compare the clinical effect between periodontal flap surgery and repeated perio-dontal scaling and root planing (scaling and root planing ,SRP) of chronic periodontitis .Methods Sam-ples of 117 single-rooted teeth ,which still had deep pockets from 5 mm to 7 mm at 6 weeks after initial therapy were selected .The right and left sides of the same patients′teeth were randomly divided into re-peated SRP group and modified Widman flap surgery group .The repeated SRP group of patients were un-dertaken scaling and root planing with local anesthesia on the troubled teeth employing Sately ultrasound therapy machines and Gracey curette ;Patients of the modified Widman flap surgery group were received modified Widman flap surgery under local anesthesia .Patients of both groups returned visit after 3 and 6 months for professional periodontal examination . Recorded and compared bleeding on probing (BOP ) , probing depth (PD) ,clinical attachment level (CAL) and gingival recession (GR) .Results BOP% ,PD , GR ,CAL values in two groups at 6 months after therapy were respectively 16 .92% ,(2 .82 ± 0 .74) mm , (5 .05 ± 1 .02) mm ,(2 .02 ± 0 .60) mm and 11 .60% ,(2 .54 ± 0 .49) mm ,(4 .90 ± 0 .83) mm ,(2 .35 ± 0 .67) mm ,which were significantly improved than those at baseline in both groups (P <0 .05) .However , BOP% ,PD and CAL values at final examination showed no significant difference between two groups (P>0 .05) .Both treatments caused gingival recession after surgery ,but gingival recession of the modified Widman flap surgery group was significantly higher than that of those received the repeated SRP group (P<0 .05) .Conclusion In our study ,both treatments showed similar effects in improving clinical periodon-tal parameters of single-rooted teeth ,and surgery produced more gingival recessions than the repeated SRP .