摘要
目的:对龈壁提升术用于高嵌体修复第二磨牙远中龈下缺损的效果展开探讨,为临床应用给予借鉴。方法:选取65例存在远中龈下缺损表现的第二磨牙,根管治疗完善后用树脂行龈壁提升,使远中缺损的边缘提升至龈上后铸瓷高嵌体修复,基于改良USPHS标准于修复后1周、半年、1年时开展随访观察,对于边缘密合性、牙体完整性、修复体折裂、边缘着色、牙龈健康状况、修复体固位、继发龋7个方面分A、B、C三级评价临床效果,并于修复前、修复后6、12个月检测远中牙龈的出血指数(BI)和牙周探诊深度(PD)评价牙周状况。结果:65例患牙均无失访,术后1周在上述七方面均评价为A级。术后6个月,共62例评价为A级,有2例嵌体脱落,给予再次粘固随访至今未脱落,有1例牙龈轻度炎症,患者增强自洁后恢复健康。术后12个月,共59例评价为A级,成功率为90.8%,有2例嵌体崩瓷,2例牙龈轻度炎症,边缘密合性、牙体完整性、边缘着色、修复体固位、继发龋方面表现良好。治疗前与修复后6个月、12个月BI、PD值差异无统计学意义(P>0.05)。结论:对于远中龈下缺损的第二磨牙,龈壁提升术用于铸瓷高嵌体修复的临床成功率高、创伤小、操作简便、对牙周健康影响小,可以作为龈下缺损不破坏生物学宽度时替代冠延长术的一种选择。
Objective:To evaluate the effect of the onlay restorations on the second molars with distal subgingival defects after deep margin elevation and to provide a reference for clinical application.Methods:After the completion of root canal treatment,65 cases of the second molar with distal subgingival defects were treated with resin filling to elevate the subgingival margin to the superior gingival margin,and were then restored with onlays of cast porcelain.At 1 week,6 months and 12 months after the restoration,the patients were followed up according to the modified USPHS criteria,and the clinical effects were evaluated in three levels:A,B and C for the following seven aspects:marginal tightness,dental integrity,restoration fracture,marginal staining,gingival health,restoration retention and secondary caries.Bleeding index(BI)and periodontal probe depth(PD)of the distal gingival were measured before treatment,and 6 and 12 months after the restoration to evaluate periodontal status.Results:None of the 65 patients lost follow-up,and all of them were rated grade A in seven aspects mentioned above at one week after the operation.At six months after the operation,62 patients were rated as grade A,and two onlays were detached,which have no shedding since the follow-up of re-adhesion,and one patient had mild gingival inflammation,who recovered after enhanced self-cleaning.At twelve months after the operation,59 cases were rated as grade A,with the success rate of 90.8%.There were 2 cases with onlay porcelain fracture and 2 cases with mild gingival inflammation,which showed satisfactory effects in such aspects as marginal tightness,dental integrity,marginal staining,restoration retention and secondary caries.There was no significant difference in BI and PD values before treatment,and 6 and 12 months after the restoration(P>0.05).Conclusion:For the second molars with distal subgingival defects,deep margin elevation has a high clinical success rate,less trauma,simple operation and little impact on periodontal health for onlays restoration of cast porcelain,which can be used as an alternative to crown lengthening surgery when the subgingival defects do not damage the biological width.
作者
申林
汪婷婷
SHEN Lin;WANG Ting-ting(Department of Stomatology,Beijing First Hospital of Integrated Chinese and Western Medicine,Beijing 100026,China)
出处
《口腔颌面修复学杂志》
2021年第2期86-91,共6页
Chinese Journal of Prosthodontics
基金
院所协同创新科研专项基金(项目编号:YZ-1920)。
关键词
第二磨牙
龈下缺损
龈壁提升术
树脂
高嵌体
second molar
subgingival defects
deep margin elevation
resin
onlay
