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目的比较牙冠延长术与牙龈切除术对牙体缺损达龈下患牙的牙龈修整后的临床疗效。方法选取186颗松动度(MD)≤Ⅰ度、牙体缺损达龈下1.5～4.0mm的上颌前牙,按缺损最深位点处的探诊深度(PD)分为浅缺损组(94颗患牙,PD<2.5mm)和深缺损组(92颗患牙,PD2.5～4mm)。每组患牙均分,分别采用牙龈切除术和牙冠延长术进行牙龈修整术,术后2周常规修复,术后12个月回访。分别记录术前、术后2周及12个月后三个时点的PD、MD和龈沟出血指数(SBI),所得数据用单因素方差分析进行统计分析。结果在浅缺损组,二种术式均可显著降低PD和SBI(P<0.05),同时二种术式中MD均增加(P<0.05),但二种术式之间PD和SBI的降低和MD的增加差异均无统计学意义(P>0.05)。在深缺损组,牙冠延长术组PD和SBI的降低值均高于牙龈切除术组(P<0.05),但前者MD增加的数值较后者明显(P<0.05)。结论当牙体缺损位于龈下且不侵犯生物学宽度时,可采用牙龈切除术进行牙龈的修整;当牙体缺损位于龈下且侵犯生物学宽度时,采用牙冠延长术修整牙龈疗效较好,但因术后MD有增大趋势,故选择适应症时应慎重。
Objective To compare the clinical effects of crown extension and gingival excision on the gingival trimming of dental implants. Methods One hundred and sixteen maxillary anterior teeth with degrees of freedom (MD) less than or equal to Ⅰ, and tooth defects up to 1.5-4.0 mm below the subgingival margin were selected and divided into shallow defect group (94 patients Tooth, PD <2.5mm) and deep defect group (92 teeth, PD 2.5 ~ 4mm). Gingival trimming was performed using gingival excision and crown extension respectively. The patients were routinely repaired 2 weeks after operation and were followed up for 12 months. The PD, MD, and sulcus bleeding index (SBI) were recorded before operation, 2 weeks and 12 months after operation. The data were analyzed by one-way ANOVA. Results Both PD and SBI significantly decreased PD and SBI (P <0.05), while both MD and MD increased in both groups (P <0.05), but both PD and SBI decreased And MD increased no significant difference (P> 0.05). In the deep defect group, the reduction of PD and SBI in the crown extension group was higher than that in the gingival excision group (P <0.05), but the value of MD in the former group was significantly higher than the latter (P <0.05). Conclusion Gingival retraction may be used for gingival retraction when the dental defect is subgingival and does not invade the biological width. When the dental defect is under the subgingival and invades the biological width, it is better to treat the gum with crown extension , But because of postoperative MD have an increasing trend, so choose indications should be careful.