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目的探讨残根不同断面水平的牙周处理的疗效作用,分析残根保留牙周手术适应证。方法 85例患者(187颗患牙)入选本研究,根据残根断面位置和牙周手术方式分成三组:治疗1组(T1)67颗,PD≥3 mm,牙槽嵴顶至残根断缘距离≥4mm,实施牙龈切除术;治疗2组(T2)71颗,PD<2 mm,牙槽嵴顶至残根断缘距离<3 mm,实施牙冠延长术;对照组49颗,PD<2 mm,牙槽嵴顶至残根断缘距离<3 mm,实施牙龈切除术;术后常规桩冠修复,观察术前、术后1周、4周、6个月和1年的SBI、GI和松动度,比较各组术后1周和1年成功率。结果残根保存率为97.3%;T1组和T2组在术后各时间点SBI、GI与对照组比较明显降低,在术后6个月和1年时松动牙所占比率比术前降低,对照组在6个月和1年时松动牙所占比率比术前增加;T1组和T2组术后1周和1年成功率显著高于对照组。结论残根不同断面水平采取不同牙周处理对残根保存修复有重要意义,可显著提高成功率。
Objective To investigate the effect of periodontal treatment on different sections of residual root and to analyze the indication of remaining periodontal surgery. Methods A total of 85 patients (187 teeth) were enrolled in this study. They were divided into three groups according to the location of the root segment and periodontal surgery: 67 in group 1 (T1), PD≥3 mm, The distance between the crest of the alveolar ridge and the root of the residual root was less than 3 mm, and the extension of the crown was performed. 49 of the control group (PD) <2 mm, the distance between the crest of the alveolar ridge and the residual root was less than 3 mm, and the gingival excision was performed. The conventional post crown restoration was performed. The SBI (preoperative, postoperative 1 week, 4 weeks, 6 months and 1 year) , GI and degree of loosening. The success rates of one week and one year after operation were compared between groups. Results The survival rate of residual roots was 97.3%. Compared with the control group, the SBI and GI of T1 group and T2 group were significantly decreased at each time point after operation, and the proportion of loose tooth was decreased at 6 and 1 year after operation. The control group at 6 months and 1 year, the proportion of loose teeth increased preoperatively; T1 and T2 group 1 week and 1 year after the success rate was significantly higher than the control group. Conclusion Different periodontal treatment at different cross-sectional levels of residual roots is of great significance for preservation and repair of residual roots, which can significantly improve the success rate.