中国医药导报
中國醫藥導報
중국의약도보
CHINA MEDICAL HERALD
2015年
1期
52-55
,共4页
前牙牙体缺损%冠延长术%修复
前牙牙體缺損%冠延長術%脩複
전아아체결손%관연장술%수복
Anterior teeth defect%Surgical crown lengthening%Repair
目的：对前牙牙体缺损达龈下的患者行冠延长术，探讨冠延长适应证、手术方法及术后修复方法和效果。方法收集2009年6月~2013年3月于中国中医科学院广安门医院就诊的前牙牙体缺损达龈下患者36例(41颗患牙)，行牙冠延长术，牙体缺损位于龈下<2 mm，采用龈切除术；牙体缺损位于龈下2~4 mm，采用翻瓣去骨及骨成形术，术后6~8周行全冠修复。比较修复效果及修复前后龈沟出血指数(SBI)、菌斑指数(PLI)，松动度(TM)、延长出的冠高度、黑三角发生率。结果①41颗患牙的牙体缺损断面术后均暴露，无松动；1年后仅1例出现冠脱落，其余良好。②术后6、12周SBI(0.98，0.76)、PLI(0.70，0.44)低于术前(2.35，1.52)，TM(0.65，0.52)高于术前(0.37)，差异有统计学意义(P<0.05)。③术后6周[(3.02±0.51)mm]、12周[(3.24±0.59)mm]延长出的冠高度均高于术后2周[(2.35±0.46)mm]，差异有统计学意义(P<0.05)。④修复即刻(78.05%)、修复后6个月(21.95%)、修复后12个月(19.51%)黑三角发生率差异有统计学意义(P<0.05)。⑤修复后12个月SBI(1.14)、PLI(0.71)高于修复即刻(0.76，0.44)，差异有统计学意义(P<0.05)。结论通过严格控制冠延长术适应证和术后修复方法，以及正确牙周护理，前牙牙体缺损达龈下可获得满意的临床修复效果。
目的：對前牙牙體缺損達齦下的患者行冠延長術，探討冠延長適應證、手術方法及術後脩複方法和效果。方法收集2009年6月~2013年3月于中國中醫科學院廣安門醫院就診的前牙牙體缺損達齦下患者36例(41顆患牙)，行牙冠延長術，牙體缺損位于齦下<2 mm，採用齦切除術；牙體缺損位于齦下2~4 mm，採用翻瓣去骨及骨成形術，術後6~8週行全冠脩複。比較脩複效果及脩複前後齦溝齣血指數(SBI)、菌斑指數(PLI)，鬆動度(TM)、延長齣的冠高度、黑三角髮生率。結果①41顆患牙的牙體缺損斷麵術後均暴露，無鬆動；1年後僅1例齣現冠脫落，其餘良好。②術後6、12週SBI(0.98，0.76)、PLI(0.70，0.44)低于術前(2.35，1.52)，TM(0.65，0.52)高于術前(0.37)，差異有統計學意義(P<0.05)。③術後6週[(3.02±0.51)mm]、12週[(3.24±0.59)mm]延長齣的冠高度均高于術後2週[(2.35±0.46)mm]，差異有統計學意義(P<0.05)。④脩複即刻(78.05%)、脩複後6箇月(21.95%)、脩複後12箇月(19.51%)黑三角髮生率差異有統計學意義(P<0.05)。⑤脩複後12箇月SBI(1.14)、PLI(0.71)高于脩複即刻(0.76，0.44)，差異有統計學意義(P<0.05)。結論通過嚴格控製冠延長術適應證和術後脩複方法，以及正確牙週護理，前牙牙體缺損達齦下可穫得滿意的臨床脩複效果。
목적：대전아아체결손체간하적환자행관연장술，탐토관연장괄응증、수술방법급술후수복방법화효과。방법수집2009년6월~2013년3월우중국중의과학원엄안문의원취진적전아아체결손체간하환자36례(41과환아)，행아관연장술，아체결손위우간하<2 mm，채용간절제술；아체결손위우간하2~4 mm，채용번판거골급골성형술，술후6~8주행전관수복。비교수복효과급수복전후간구출혈지수(SBI)、균반지수(PLI)，송동도(TM)、연장출적관고도、흑삼각발생솔。결과①41과환아적아체결손단면술후균폭로，무송동；1년후부1례출현관탈락，기여량호。②술후6、12주SBI(0.98，0.76)、PLI(0.70，0.44)저우술전(2.35，1.52)，TM(0.65，0.52)고우술전(0.37)，차이유통계학의의(P<0.05)。③술후6주[(3.02±0.51)mm]、12주[(3.24±0.59)mm]연장출적관고도균고우술후2주[(2.35±0.46)mm]，차이유통계학의의(P<0.05)。④수복즉각(78.05%)、수복후6개월(21.95%)、수복후12개월(19.51%)흑삼각발생솔차이유통계학의의(P<0.05)。⑤수복후12개월SBI(1.14)、PLI(0.71)고우수복즉각(0.76，0.44)，차이유통계학의의(P<0.05)。결론통과엄격공제관연장술괄응증화술후수복방법，이급정학아주호리，전아아체결손체간하가획득만의적림상수복효과。
Objective To carry out surgical crown lengthening for patients with subgingival tooth defect of the anterior teeth crown, discuss the selection of indications, surgical techniques, postoperative repair methods and effects. Meth-ods 36 patients with a total of 41 teeth structure defect were selected from June 2009 to March 2013 in Guang' anmen Hospital, China Academy of Traditional Chinese Medicine. All of them were treated with anterior subgingival surgical crown lengthening. Patients whose subgingival tooth defect located< 2 mm, treated with gingival resection; patients whose subgingival tooth defect located 2-4 mm, treated with boneless and bone flap angioplasty. They were given full crown restoration after 6-8 weeks. The repair effects, sulcus bleeding index (SBI), plaque index (PLI), loose degrees (TM), extend the height of the crown, black triangle incidence before and after restoration were compared. Results①There were 41 teeth of defects section exposed, no loose after operation; only 1 case occurred teeth crown off, the rest was good 1 year after restoration.②SBI (0.98, 0.76), PLI (0.70, 0.44) 6 weeks after surgery, 12 weeks after surgery were lower than before surgery (2.35,1.52), TM (0.65, 0.52) was higher than before surgery (0.37), the differences were statistically significant (P<0.05).③The height of the prolonged crown 6 weeks after surgery [(3.02±0.51) mm], 12 weeks after surgery [(3.24±0.59) mm] were higher than 2 weeks after surgery [(2.35±0.46) mm], the differences were statisti-cally significant (P<0.05).④There were significant differences in the incidence of black triangle among repair imme-diately (78.05%), 6 months after repair (21.95%), 12 months after repair (19.51%), the difference was statistically sig-nificant (P< 0.05). ⑤12 months after repair SBI (1.14), PLI (0.71) were higher than repaired immediately (0.76, 0.44), the differences were statistically significant (P< 0.05). Conclusion Under strict control of surgical crown lengthening and postoperative indications repair methods and the proper periodontal care, subgingival tooth defect of the anterior teeth crown can obtain satisfactory clinical results.
