改良牙冠延长术与正畸牵引加牙冠延长术在上前牙龈体缺损中的应用效果比较
2024-04-21 16:11:52纪生华
医学美学美容
2024年5期
纪生华
[摘 要]目的 比較改良牙冠延长术与正畸牵引加牙冠延长术在上前牙龈体缺损中的应用效果。方法选取我院2018年5月-2023年5月收治的82例上前牙龈体缺损患者为研究对象，根据治疗方案不同分为对照组与研究组，各41例。对照组予以改良牙冠延长术治疗，研究组予以正畸牵引加牙冠延长术治疗，比较两组修复效果、牙周健康指标、牙冠高度变化、并发症发生情况及美学效果满意度。结果 研究组修复优良率为95.12%，高于对照组的78.05%（P<0.05）；两组术后12周探诊深度、牙龈指数、龈沟出血指数、菌斑指数及牙齿松动度均优于术前（P<0.05），但研究组与对照组比较，差异无统计学意义（P>0.05）；两组术后12周牙冠高度变化均高于术后2周（P<0.05），但研究组与对照组比较，差异无统计学意义（P>0.05）；研究组并发症发生率略低于对照组，但差异无统计学意义（P>0.05）；研究组美学效果满意度高于对照组（P<0.05）。结论 改良牙冠延长术与正畸牵引加牙冠延长术均可有效改善牙周健康状况及冠高度，且安全性高，但正畸牵引加牙冠延长术修复效果及美学效果更好，在上前牙龈体缺损治疗中应用价值更高。
[关键词] 改良牙冠延长术；正畸牵引；上前牙龈体缺损；牙冠高度
[中图分类号] R783.3 [文献标识码] A [文章编号] 1004-4949（2024）05-0009-04
Comparison of the Application Effects of Modified Crown Lengthening and Orthodontic Traction Plus Crown Lengthening in Gingival Defect of Upper Anterior Teeth
JI Sheng-hua
（Department of Stomatology， Wuwei Maternal and Child Health and Family Planning Service Center， Wuwei 733000， Gansu， China）
[Abstract]Objective To explore the treatment effect of modified crown lengthening and orthodontic traction plus crown lengthening in gingival defect of upper anterior teeth. Methods A total of 82 patients with anterior gingival defect admitted to our hospital from May 2018 to May 2023 were selected as the research objects. According to different treatment schemes， they were divided into control group and study group， with 41 patients in each group. The control group was treated with modified crown lengthening， and the study group was treated with orthodontic traction and crown lengthening. The repair effect， periodontal health index， crown height change， complications and aesthetic effect satisfaction were compared between the two groups. results of the study group were compared with the control group. Results The excellent and good rate of repair in the study group was 95.12%， which was higher than 78.05% in the control group （P<0.05）. The probing depth， gingival index， gingival sulcus bleeding index， plaque index and tooth mobility of the two groups at 12 weeks after operation were better than those before operation （P<0.05）， but there was no significant difference between the study group and the control group （P>0.05）. The changes of crown height in the two groups at 12 weeks after operation were higher than those at 2 weeks after operation （P<0.05）， but there was no significant difference between the study group and the control group （P>0.05）. The incidence of complications in the study group was slightly lower than that in the control group， but the difference was not statistically significant （P>0.05）. The aesthetic effect satisfaction of the study group was higher than that of the control group （P<0.05）. Conclusion Both modified crown lengthening and orthodontic traction plus crown lengthening can effectively improve periodontal health and crown height， and have high safety. However，orthodontic traction plus crown lengthening has better repair effect and aesthetic effect， and has higher application value in the treatment of upper anterior gingival defect.
[Key words] Modified crown lengthening； Orthodontic traction； Upper anterior gingival body defect； Crown height
上前牙龈体缺损（upper anterior gingival body defect）属于牙缺损中的常见类型，又称复杂根折，多因龋齿、直接或间接暴力所致，患牙常因生理解剖结构丧失而影响其外部形态及咬合功能，若未及时治疗可引发牙龈炎、牙髓炎等，不利于口腔健康[1]。牙冠延长术能有效保留残根，经改良后可减少去骨量，并对牙根进行精细打磨，通过重塑断缘生物学宽度二维残冠为修复创造优良条件[2]。但因患牙冠根或解剖特殊结构，常规牙冠延长术可能引起患者牙周组织发生炎症。正畸牵引是将残根沿冠向牵拉促使牙槽骨移动并向受力方向增生，有助于重建生物学宽度以提高邻牙与患牙牙龈协调的美观度[3]。本研究旨在比较改良牙冠延长术与正畸牵引加牙冠延长术在上前牙龈体缺损中的应用效果，现报道如下。
