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目的探讨牙冠延长术技术细节的改良方法。方法选择2010年5月至2013年10月在广西医科大学附属口腔医院牙周黏膜科就诊的因龋坏、外伤等原因所致的全部或部分牙根根面位于龈下的残根或残冠患者34例(患牙38颗),均采用牙冠延长术治疗,术中采用改良球钻、EX-21EF车针等技术细节处理,术后6周进行临床效果评价。结果 26颗患牙评价为满意,占68.4%;7颗基本满意,占18.4%;5颗不满意,占13.2%,其中2颗患牙邻面暴露不佳,1颗患牙根分叉区断面暴露不佳,2颗患牙龈缘与邻牙明显不协调。结论使用改良球钻和EX-21EF车针可提高牙冠延长术中去骨效率和效果;行内斜切口、去除游离牙龈后,测量并记录切端牙体组织至龈缘距离,此距离增加3 mm即为预期去骨位置,该方法简单可靠,对术前断面位于龈上或龈下的患牙均适用;缝合后再用高频电刀切除和修整腭侧龈瓣,可使龈瓣更准确地复位于预期位置。
Objective To explore the improvement of technique of crown extension. Methods From May 2010 to October 2013 in the Department of Stomatology, Affiliated Stomatological Hospital of Guangxi Medical University due to caries, trauma and other causes of all or part of the roots of the root surface of the subgingival root or residual crown patients 34 cases (38 teeth) were treated with crown extension. The patients were treated with modified ball drill and EX-21EF needle. The clinical effect was evaluated 6 weeks after operation. Results 26 teeth were evaluated as satisfactory, accounting for 68.4%; 7 were satisfied basically, accounting for 18.4%; 5 were unsatisfactory, accounting for 13.2% Poor exposure, 2 gingival margin of the teeth and adjacent teeth significantly inconsistent. Conclusions The improved ball drill and EX-21EF needle can improve the efficiency and effectiveness of bone removal during crown extension. After removing the free gums, the distance between the incisor body and gingival margin was measured and recorded. The distance increased by 3 mm Which is the expected location of the bone, the method is simple and reliable, preoperative section of the supragingival or subgingival teeth are applicable; suture and then use high-frequency electric knife to remove and repair the palatine gingival flap, the gingival flap can be more accurate Reset to the desired location.