不同合金套筒冠义齿对中重度牙周病伴牙列缺损修复效果的临床观察

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目的通过观察圆锥型套筒冠义齿对中重度牙周病伴牙列缺损患者修复治疗前后基牙牙周组织变化情况,了解其临床疗效。方法选择27例中重度牙周病伴牙列缺损的病例,患牙经过牙周基础治疗和根管治疗后,采用圆锥型套筒冠义齿修复,共制作36副圆锥型套筒冠义齿,其中29副使用镍铬合金制作套筒冠内外冠,7副使用金合金制作筒冠套内外冠。基牙共183颗,其中Ⅰ度松动28颗,Ⅱ度松动139颗,Ⅲ度松动16颗。平均随访3.5年,观察基牙菌斑指数、牙龈指数、牙周袋深度、牙松动度以及影像学改变。结果 27例中重度牙周病伴牙列缺损的病例,基牙松动度降低,牙周袋变浅,附着丧失部分恢复,牙周组织的健康情况得到显著改善(P<0.01),X片显示:修复后基牙牙周膜无明显增宽,骨小梁致密,排列整齐,骨质密度明显增高。牙槽骨高度未见降低,部分可见增高。患者主观感觉满意,金合金套筒冠义齿的牙周健康改善尤为明显。结论圆锥型套筒冠义齿对中重度牙周病伴牙列缺损是一种较理想的修复治疗方法,内外冠选用金合金制作的圆锥型套筒冠义齿可达到更好的治疗效果。 Objective To observe the changes of periodontal tissues in patients with moderate-severe periodontal disease and dentition defect before and after restoration by observing the cone-shaped canopy dentures, and to understand the clinical effect. Methods Twenty-seven cases of moderate and severe periodontal disease with dentition defect were selected. After periodontal basic treatment and root canal treatment, the teeth were repaired with conical sleeve denture, 36 conical telescopic canopy dentures were made, of which, 29 pairs of nickel-chrome alloy sleeve crown inside and outside the crown, 7 pairs of gold alloy crown tube crown inside and outside the crown. A total of 183 abutments, including Ⅰ degree loose 28, Ⅱ loosen 139, Ⅲ degree loosen 16. After a mean follow-up of 3.5 years, the plaque index, gingival index, periodontal pocket depth, tooth mobility and imaging changes were observed. Results Twenty-seven patients with moderate-severe periodontal disease complicated with dentition defect, the mobility of abutment decreased, the periodontal pocket became shallow, the loss of attachment recovered partially, the health condition of periodontal tissue was significantly improved (P <0.01) : After repair, the periodontal ligament of the abutment had no obvious broadening, the trabecular bone was dense and neatly arranged, the bone density was obviously increased. Alveolar bone height was not reduced, some of the visible increase. Patients subjective feeling satisfied, gold alloy crown denture periodontal health improvement is particularly evident. Conclusion Conical telescopic canopy dentition is an ideal method for the treatment of moderate and severe periodontal disease with dentition defect. The inner and outer crowns can be treated with conical sleeve denture made of gold alloy to achieve better therapeutic effect.
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