两种排龈方法在楔状缺损修复中的应用研究

摘要

Objective To investigate the influence of two gingival retraction techniques on the periodontium and clinical performance before the restoration of cervical lesion. Methods 150 teeth with cervical lesion of 50 patients were selected. The teeth were divided into 3 groups randomly. In the experiment group, a conventional retraction cord ( Ultrapaks) and a paste-like material (Expasyls) were applied on the buccal aspects of each subject. In the control group, no gingival retraction techniques was applied before restoration and filled directly. Bleeding on probing and the pain were assessed after application. The retention, marginal adaptation, the presence of secondary caries and the GI after one year were evaluated . Data were analysed using Chi-Square and Kruskal - Wallis tests (a = 0. 05). Results There were significant difference between the rates of subjective feeling of the Ultrapaks and Expasyls. Bleeding was only induced by Ultrapaks in five subjects. After one year, the differences between the experimental and control groups in GI and marginal adaptation were of statistical significance ( P < 0.05 ). While there were no significant difference between the two control groups. The retention of the restoration and the presence of secondary caries were not statistically significant among the 3 groups. Conclusion Utilization of gingival retraction techniques before the restoration of cervical lesions can efficiently improve the quality of the restoration and the two gingival retraction methods were not statistically significant. The cordless gingival retraction technique is more easy, feasible, rapid than the retraction cord.%目的 研究在楔状缺损修复前使用两种排龈方法对其牙周组织及充填效果的影响.方法 选择50例全口至少有3个楔状缺损位于龈缘或龈下的患者(150颗患牙),每例患者的患牙随机分为3组,对照组直接树脂修复,实验组分别用ULTRA排龈线,Expusyl排龈膏排龈后再充填.分别在治疗后记录牙龈出血(BOP)及患者主观感受,1年后记录患牙牙龈指数(GI),并参考改良USPHS评价系统进行综合临床评价,观察充填体脱落,继发龋及边缘密合情况.结果 充填后疼痛发生率:排龈线组与排龈膏组差异有统计学意义,排龈线组有5例出血;1年后两实验组与对照组比较,牙龈指数和边缘密和性差异均有统计学意义,而两种排龈方法比较,差异无统计学意义.充填体脱落率和继发龋三组差异均无统计学意义.结论 在楔状缺损修复前进行排龈,可有效地保护牙周组织,提高充填质量.两种排龈方法均可达到理想临床效果,无创性排龈较排龈线操作时间短,简便舒适.