烤瓷夹板联合植骨修复牙周骨缺损基牙牙周的变化

摘要

BACKGROUND:Splint-like porcelain-fused-metal bridge for periodontal bone defects accompanied by dentition defects induced by periodontitis can increase the bone mineral density rather than bone height around the tooth root. Therefore, there are some limitations for pure splint treatment in the repair of periodontitis-induced n periodontal bone defects accompanied by dentition defects. n OBJECTIVE:To compare the restoration method of bone graft in combination with splint-like n porcelain-fused-metal bridge treatment and splint-like porcelain-fused-metal bridge alone on curing periodontal disease patients with periodontal bone defects, and to analyze the periodontal conditions. n METHODS:Twenty patients with periodontitis accompanied by Kennedy III dentition defects, who had alveolar bone absorption and were scheduled for porcelain crown treatment, were randomly divided into bone graft group and non-bone graft group, 10 patients in each group. In the bone graft group, bone graft plus splint-like n porcelain-fused-metal bridge was performed;only splint-like porcelain-fused-metal bridge was in the non-bone graft group. Gingival crevicular fluid samples from the groups were col ected at 0, 3, 6 months after treatment for measurement of interleukin-1βlevel. Probing depth and clinical attachment loss were also reexamined and recorded. n RESULTS AND CONCLUSION:Interleukin-1βlevel decreased gradual y in the two groups (P<0.05), which was decreased more significantly in the bone graft group as compared with the non-bone graft (P<0.05). As time went by, the probing depth and clinical attachment loss were also decreased in the two groups, which were more significant in the bone graft group (P<0.05). In addition, there were significant differences in the probing depth and clinical attachment loss of the bone graft group at different time (P<0.05). These findings indicate that the combination of periodontal bone graft and splint-like porcelain-fused-metal bridge is more effective and beneficial to periodontal tissue reconstruction with periodontal bone defects than the simple splint-like porcelain-fused-metal bridge.%　　背景：采用夹板式固定义齿修复牙周炎致牙周骨缺损伴牙列缺损可增加根周骨质骨密度，但并未增加骨高度，因此，仅运用单纯的夹板式固定修复牙周炎致牙周骨缺损伴牙列缺损具有一定的局限性。n　　目的：对比牙周植骨联合夹板式烤瓷联冠与单纯夹板式烤瓷联冠修复牙周病致牙周骨缺损患者基牙的牙周变化。n　　方法：选择牙周炎伴KennedyⅢ类牙列缺损、远中牙牙槽骨角形吸收拟行烤瓷冠修复患者20例，抽签随机分为试验组与对照组，每组10例。试验组采用牙周植骨联合夹板式烤瓷联冠修复，对照组采用单纯夹板式烤瓷联冠修复，夹板戴入后0，3，6个月采集两组待测基牙龈沟液，检测龈沟液中白细胞介素1β水平，并复查和记录探诊深度与临床附着丧失。n　　结果与结论：两组龈沟液中白细胞介素1β水平均随着时间推移逐渐下降(P <0.05)，且不同时间点试验组下降程度高于对照组(P<0.05)。两组基牙探诊深度、临床附着丧失均随着时间推移逐渐下降，不同时间点试验组较对照组下降更明显(P <0.05)，且试验组组内不同时间点各指标差异有显著性意义(P <0.05)。结果表明牙周植骨联合夹板式烤瓷联冠较单纯夹板式烤瓷联冠修复方法更利于维持和促进牙周骨缺损患者基牙的健康，并可获得较满意的近期临床疗效。