牙冠延长术后观察
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摘要
目的:通过临床病例探讨牙齿牙冠延长术术后修复的疗效及恢复情况。
方法:对10例患者行牙冠延长术,依手术前牙齿断缘位于牙槽嵴顶的位置,比较术前、术后4一6周效果,通过术后1、4、6周的预后效果的临床观察,比较10例患者术前、术后的(1)术后牙龈的色、形、质的改变,断端暴露是否良好;(2)术后的菌斑指数(PLI)、出血指数(BI)和松动度(MD);(3)术前后断端位置:牙槽嵴顶与断端的距离和牙槽嵴顶与牙龈的距离,(4)术后的前牙龈缘的位置与相邻牙龈缘的位置关系(唇舌侧),术后上前牙牙龈乳头的术后恢复。
结果:患牙主观感觉良好,无叩痛,牙龈无炎症,牙龈缘高度与邻牙协调, X线片示牙周、尖周、牙槽嵴无异常。牙齿断端劈裂至龈下1-2㎜的比到龈下3-4㎜的效果要显著的多。
结论:牙冠延长术的实施有利于断缘位于牙龈下方而生物学宽度不够的牙齿保存和修复,为以后牙齿修复后牙周情况的健康打下良好的基础。
Objective:to investigate the efficacy and recovery of clinical cases of teeth through crown lengthening surgery
Methods: supply crown lengthening surgery to 10 sick teeth, according to pre-operative off the teeth and lingual margin to the alveolar ridge defect depth under the crown were divided into two groups, two groups were compared before and after a 6 weeks 4 results, The postoperative 1, 4, 6-week prognosis of clinical observation, two groups were compared before and after operation: (1) the change of color, shape, quality and good stump exposures in gum after;(2) the plaque index, bleeding index and mobility degree after operation ;(3) position before and after surgery ends: the top and the ends of the alveolar ridge alveolar crest distance and the distance with gum;(4) cingival margin after the first position and the position relationship between the adjacent gingival margin (tongue side), upper anterior gingival papillae after postoperative recovery
Results: Subjective feeling good ofsick teeth, no percussion pain, no gum inflammation, gingival margin height of coordination with adjacent teeth, X-ray film showed periodontal, periapical, alveolar ridge without exception. Meanwhile, off in the gingival margin of the teeth under the effect of 2.5mm or less than the broken edge in the subgingival tooth between 2.5mm to 4mm achieve much more.
Conclusions: It benifits the preservation and restoration of alveolar crest off the bottom edge of the teeth by Crown lengthening surgery.To lay a good foundation for the health of periodontal through dental restorations
方法:对10例患者行牙冠延长术,依手术前牙齿断缘位于牙槽嵴顶的位置,比较术前、术后4一6周效果,通过术后1、4、6周的预后效果的临床观察,比较10例患者术前、术后的(1)术后牙龈的色、形、质的改变,断端暴露是否良好;(2)术后的菌斑指数(PLI)、出血指数(BI)和松动度(MD);(3)术前后断端位置:牙槽嵴顶与断端的距离和牙槽嵴顶与牙龈的距离,(4)术后的前牙龈缘的位置与相邻牙龈缘的位置关系(唇舌侧),术后上前牙牙龈乳头的术后恢复。
结果:患牙主观感觉良好,无叩痛,牙龈无炎症,牙龈缘高度与邻牙协调, X线片示牙周、尖周、牙槽嵴无异常。牙齿断端劈裂至龈下1-2㎜的比到龈下3-4㎜的效果要显著的多。
结论:牙冠延长术的实施有利于断缘位于牙龈下方而生物学宽度不够的牙齿保存和修复,为以后牙齿修复后牙周情况的健康打下良好的基础。
Objective:to investigate the efficacy and recovery of clinical cases of teeth through crown lengthening surgery
Methods: supply crown lengthening surgery to 10 sick teeth, according to pre-operative off the teeth and lingual margin to the alveolar ridge defect depth under the crown were divided into two groups, two groups were compared before and after a 6 weeks 4 results, The postoperative 1, 4, 6-week prognosis of clinical observation, two groups were compared before and after operation: (1) the change of color, shape, quality and good stump exposures in gum after;(2) the plaque index, bleeding index and mobility degree after operation ;(3) position before and after surgery ends: the top and the ends of the alveolar ridge alveolar crest distance and the distance with gum;(4) cingival margin after the first position and the position relationship between the adjacent gingival margin (tongue side), upper anterior gingival papillae after postoperative recovery
Results: Subjective feeling good ofsick teeth, no percussion pain, no gum inflammation, gingival margin height of coordination with adjacent teeth, X-ray film showed periodontal, periapical, alveolar ridge without exception. Meanwhile, off in the gingival margin of the teeth under the effect of 2.5mm or less than the broken edge in the subgingival tooth between 2.5mm to 4mm achieve much more.
Conclusions: It benifits the preservation and restoration of alveolar crest off the bottom edge of the teeth by Crown lengthening surgery.To lay a good foundation for the health of periodontal through dental restorations
引文
1.Paul E, Lovdahl. Periodontal managem ent and root extrusion oftraumatized teeth[ J] . Dent Clin North Am, 1995, 39( 1) : 169~179.
2.Allen EP,Surgical crown Lengthening tor tunction and esthetics.Dent Clin North Am,1993, 37: 163~179
3.Dolt AH 3rd ,Robbins JW.Altered passive eruption:an etiology of short clinical crowns. Quintessece Int,1997,28:363~372
4.Parashis A,Tripodakis A..Crown Iengthening and restorative treatment in mutilated molars. Quintessence Int,1994,25:167~172
5.Ingber JS,Rose LF,Coslet JG.The“biologic width”—a concept in periodontics and restorative dentistry.Alpha Omegan,1977,70:62~65
6.曹采方.牙周病学[M].北京:人民卫生出版社,2001:87-90,219
7.曹采方.临床牙周病学[ M ].北京:北京大学医学出版社,2006:349.
8.AnthonyW, Gargiulo, FrankM. et al. Dimensions and relations of the dentogingival junction in humans [ J ]. J Periodontology,1961, 32∶261
9.胡文杰,李连生,张豪,彭东.牙根改形结合少量去骨:一种改良的牙冠延长术[J]北京大学学报(医学版), 2008, (01)
10.韩蔚,欧阳翔英,王新知1牙冠延长术的疗效及影响因素分析1中华口腔医学杂志, 2004, 39 (4) , 28022831
11.Ingber JS, Rose LF, Coslet JG1 The " biologic width" 22a concep tinperiodontics and restorative dentistry1 Alpha Omegan, 1977, 70(3) : 622651
12.Fugazzoto PA1 Periodontal restorative interrelationship s: the isolated restoration1 J AmDent Assoc, 1985, 110 (6) : 91529171
13.Allen EP1 Surgical crown lengthening for function and esthetics1Dent Clin North Am, 1993, 37 (2) : 1632791
14.Wagenberg BD, Eskow RN, Langer B1 Exposing adequate tooth structure for restorative dentistry1 Int J Periodontics RestorativeDent,1989, 9 (5) : 32223311
15.韩蔚译.灵长类动物牙冠延长术后生物学宽度的形成[ J ]1中国口腔医学继续教育杂志, 2000, 3( 3) : 17- 23
16.Jesses FB. Anatomy and physiolgy, Reston: Reston Publishing Company.1979. 125
17.Nas hi Sato. Peri odon tal Surgerg A Clinical At las. Yuz aw a: J apan Quintnes sence Pub lish ing Co Inc, 2000. 33～36.
18.Eric Oakley, In- Chul Rhyu,Spyros Karat zas, et al. Formation of the Biolog2icWidth FollowingCrown Lengthening in Nonhuman Primat es. Int J Peri2odont Rest Dent 1999. 529- 541
19.Hermann JS, Buser D, Schenk RK, et al. Biological width around titanium implants. Clin Oral Implants Res. 2000 Feb; 11( 1) :1- 11
20.BerglundhT, Lindhe J. Biological width revisit ed. J clin Periodontol 1996,23( 10) : 971- 973
21.Maynard GJ, Wit son RD. Physiologic dimensions of the periodontium funda2mental to successful restorat ive dentistry . J Periodontol 1979, ( 50) : 107
22.欧阳翔英.有助于残根修复的牙冠延长术[J].中华口腔医学杂志,2004,39(3):205~207
23.陈丽霞.牙冠延长术结合桩核冠修复牙体缺损的临床应用[J]华夏医学, 2009,(03)
24.陈超,黄常伟.牙冠延长术在残根残冠保留修复中的临床应用.福建医药杂志,2003, 25 (6):37
25.A llen EP. Surg ical crown lengthen ing for fun ct ion and esthetics. Dent Clin North Am, 1993, 37( 2) : 163
26.Wolffe GN, van der Weijden FA, Spanauf AJ, et al. Lengthening clin ical crow ns a solut ion for specific periodontal, rest orat ive, andesthet ic problems[ J] . Quint essence Int , 1994,25( 2) : 81~ 88.
27.Allen EP. Surgical crow n lengthening for function and esthet ics[ J] . Dent Clin North Am, 1993, 37( 2) : 163~ 179.
1.Gagiulo Aentz FM, Orban B. Dimensions and relationship of the dentogingiva l junction in humans[ J]. J Pe riodonto,l 1961, 32: 261～267.
2.Allen EP. Surgica l crown lengthening for function andesthe tics[ J] . Dent C lin No rth Am, 1993, 37: 163～179.
3.韩蔚译.灵长类动物牙冠延长术后生物学宽度的形成[ J ]1中国口腔医学继续教育杂志, 2000, 3( 3) : 17- 23
4.曹采方.牙周病学.北京:人民卫生出版社, 2001, 6- 8
5.Josef Schnidseder编著(美),章魁华,李盛琳,陈永译.美容牙科学彩色图谱[M].北京:中国医药科技出版社,2003:55
6.肖健平,杨明华,吴文蕾,等.牙冠延长术增加临床冠长度的临床研究[ J] .实用口腔医学杂志, 2004, 20(1) : 79
7.Benslmon GC. Surgical crown 2 lengthening procedure to enhance esthetics[J]. INT J Periodontics Restorative Dent, 1999, 19 (4) :332 - 341.
8.韩蔚,欧阳翔英,王新知,等.牙冠延长术的疗效及影响因素分析[ J ].中华口腔医学杂志, 2004, 39 (4) : 280 - 283.
9.Johnson RH. Lengthening clinical crowns[ J ]. J Am Dent Assoc,1990, 121: 473– 476
10.Palomo F , Kopczyk RA. Rationale and methods for crownlengthening. J Am Dent Assoc , 1978 ,96 :257～260.
11.欧阳翔英.有助于残根修复的牙冠延长术[ J].中华口腔医学杂志, 2004, 39( 3) : 205～207.
12.Jo rg ensen M G, Nowzari H. Aesthetic cr ow n leng the ning[ J] . Perio do nt olo gy 2000, 2001, 27( 1) : 45～58
13.Kim CS, Cho i SH , Chai JK, et al. Surg ical ex trusio ntechnique fo r clinical cr ow n leng thening: report o f thr eecases[ J] . Int J Periodontics Restor ativ e Dent, 2004, 24( 5) : 412～421.
14.Bensim on G C. Surgical crown length ening procedure t o en hance esthet ics [ J ] . Int J P eriodontics Rest or ativne Dent ,1999, 19( 4) : 332～341
15.韩蔚,欧阳翔英,王新知,等.牙冠延长术的疗效及影响因素分析[ J ].中华口腔医学杂志, 2004, 39 (4) : 280– 283
16.欧阳翔英.有助于残根修复的牙冠延长术[J].中华口腔医学杂志, 2004, 39( 3) : 205～207
17.Bragger U , Lauchenauer D, Lang N P. Surgical length eningof the clini cal cr ow n [ J ] . J Clin Periodontol , 1992, 19 ( 1) :58～63.
18.曹采方.牙周病学[M] .北京:人民卫生出版社, 2003.67
19.欧阳翔英.有助于残根修复的牙冠延长术[J] .中华口腔医学杂志, 2004, 39(3):205- 206
20.KebirK,Martine H.周爽英,译.对临床短冠修复和牙周治疗的考虑[J].精粹中国口腔医学继续教育杂志,1999,2(4):38-42.
21.时淑红。烤瓷修复不同肩台位置对牙周影响的比较分析[J].实用医学杂志,2007,23(20):3281.
22.黄建生,周磊,宋光保,等.前牙临床短冠牙冠延长术后烤瓷修复的临床效果观察[J].实用口腔医学,2004,20(5):547-549.
23.白乐康,胡燕萍,安虹.牙列重度磨耗患者牙合重建设计与治疗.实用口腔医学杂志, 2001, 17( 5) : 434
24.陈丽霞.牙冠延长术结合桩核冠修复牙体缺损的临床应用[J].华夏医学, 2009,03(22):477～450
25.Dolt AH 3rd, Robbins JW. Altered passiv e er uption: An etiology of shor t clinical crowns. Quintessence Int, 1997, 28 ( 6) :362
26.Lannilgsk,Waldrop Tc, Gunsolley Jc, etal. surgical crown length 2 ening: Evaluation of the biologic width [ J ]. Periodontol, 2003, 74(4) : 468 - 474.
27.常少海,叶剑涛,刘东雄,等.成人佩戴固定矫治器对牙龈健康的影响———附48例报告[ J ].新医学, 2003, 34 (8) : 108
28.杨美祥,丁寅,徐如生.正畸治疗与牙周组织健康[J].牙体牙髓牙周病杂志, 1998,8(3): 224 - 225.
29.林久祥.正畸与牙周病[M ].北京:中国医药科技出版社,1990, 650.
2.Allen EP,Surgical crown Lengthening tor tunction and esthetics.Dent Clin North Am,1993, 37: 163~179
3.Dolt AH 3rd ,Robbins JW.Altered passive eruption:an etiology of short clinical crowns. Quintessece Int,1997,28:363~372
4.Parashis A,Tripodakis A..Crown Iengthening and restorative treatment in mutilated molars. Quintessence Int,1994,25:167~172
5.Ingber JS,Rose LF,Coslet JG.The“biologic width”—a concept in periodontics and restorative dentistry.Alpha Omegan,1977,70:62~65
6.曹采方.牙周病学[M].北京:人民卫生出版社,2001:87-90,219
7.曹采方.临床牙周病学[ M ].北京:北京大学医学出版社,2006:349.
8.AnthonyW, Gargiulo, FrankM. et al. Dimensions and relations of the dentogingival junction in humans [ J ]. J Periodontology,1961, 32∶261
9.胡文杰,李连生,张豪,彭东.牙根改形结合少量去骨:一种改良的牙冠延长术[J]北京大学学报(医学版), 2008, (01)
10.韩蔚,欧阳翔英,王新知1牙冠延长术的疗效及影响因素分析1中华口腔医学杂志, 2004, 39 (4) , 28022831
11.Ingber JS, Rose LF, Coslet JG1 The " biologic width" 22a concep tinperiodontics and restorative dentistry1 Alpha Omegan, 1977, 70(3) : 622651
12.Fugazzoto PA1 Periodontal restorative interrelationship s: the isolated restoration1 J AmDent Assoc, 1985, 110 (6) : 91529171
13.Allen EP1 Surgical crown lengthening for function and esthetics1Dent Clin North Am, 1993, 37 (2) : 1632791
14.Wagenberg BD, Eskow RN, Langer B1 Exposing adequate tooth structure for restorative dentistry1 Int J Periodontics RestorativeDent,1989, 9 (5) : 32223311
15.韩蔚译.灵长类动物牙冠延长术后生物学宽度的形成[ J ]1中国口腔医学继续教育杂志, 2000, 3( 3) : 17- 23
16.Jesses FB. Anatomy and physiolgy, Reston: Reston Publishing Company.1979. 125
17.Nas hi Sato. Peri odon tal Surgerg A Clinical At las. Yuz aw a: J apan Quintnes sence Pub lish ing Co Inc, 2000. 33～36.
18.Eric Oakley, In- Chul Rhyu,Spyros Karat zas, et al. Formation of the Biolog2icWidth FollowingCrown Lengthening in Nonhuman Primat es. Int J Peri2odont Rest Dent 1999. 529- 541
19.Hermann JS, Buser D, Schenk RK, et al. Biological width around titanium implants. Clin Oral Implants Res. 2000 Feb; 11( 1) :1- 11
20.BerglundhT, Lindhe J. Biological width revisit ed. J clin Periodontol 1996,23( 10) : 971- 973
21.Maynard GJ, Wit son RD. Physiologic dimensions of the periodontium funda2mental to successful restorat ive dentistry . J Periodontol 1979, ( 50) : 107
22.欧阳翔英.有助于残根修复的牙冠延长术[J].中华口腔医学杂志,2004,39(3):205~207
23.陈丽霞.牙冠延长术结合桩核冠修复牙体缺损的临床应用[J]华夏医学, 2009,(03)
24.陈超,黄常伟.牙冠延长术在残根残冠保留修复中的临床应用.福建医药杂志,2003, 25 (6):37
25.A llen EP. Surg ical crown lengthen ing for fun ct ion and esthetics. Dent Clin North Am, 1993, 37( 2) : 163
26.Wolffe GN, van der Weijden FA, Spanauf AJ, et al. Lengthening clin ical crow ns a solut ion for specific periodontal, rest orat ive, andesthet ic problems[ J] . Quint essence Int , 1994,25( 2) : 81~ 88.
27.Allen EP. Surgical crow n lengthening for function and esthet ics[ J] . Dent Clin North Am, 1993, 37( 2) : 163~ 179.
1.Gagiulo Aentz FM, Orban B. Dimensions and relationship of the dentogingiva l junction in humans[ J]. J Pe riodonto,l 1961, 32: 261～267.
2.Allen EP. Surgica l crown lengthening for function andesthe tics[ J] . Dent C lin No rth Am, 1993, 37: 163～179.
3.韩蔚译.灵长类动物牙冠延长术后生物学宽度的形成[ J ]1中国口腔医学继续教育杂志, 2000, 3( 3) : 17- 23
4.曹采方.牙周病学.北京:人民卫生出版社, 2001, 6- 8
5.Josef Schnidseder编著(美),章魁华,李盛琳,陈永译.美容牙科学彩色图谱[M].北京:中国医药科技出版社,2003:55
6.肖健平,杨明华,吴文蕾,等.牙冠延长术增加临床冠长度的临床研究[ J] .实用口腔医学杂志, 2004, 20(1) : 79
7.Benslmon GC. Surgical crown 2 lengthening procedure to enhance esthetics[J]. INT J Periodontics Restorative Dent, 1999, 19 (4) :332 - 341.
8.韩蔚,欧阳翔英,王新知,等.牙冠延长术的疗效及影响因素分析[ J ].中华口腔医学杂志, 2004, 39 (4) : 280 - 283.
9.Johnson RH. Lengthening clinical crowns[ J ]. J Am Dent Assoc,1990, 121: 473– 476
10.Palomo F , Kopczyk RA. Rationale and methods for crownlengthening. J Am Dent Assoc , 1978 ,96 :257～260.
11.欧阳翔英.有助于残根修复的牙冠延长术[ J].中华口腔医学杂志, 2004, 39( 3) : 205～207.
12.Jo rg ensen M G, Nowzari H. Aesthetic cr ow n leng the ning[ J] . Perio do nt olo gy 2000, 2001, 27( 1) : 45～58
13.Kim CS, Cho i SH , Chai JK, et al. Surg ical ex trusio ntechnique fo r clinical cr ow n leng thening: report o f thr eecases[ J] . Int J Periodontics Restor ativ e Dent, 2004, 24( 5) : 412～421.
14.Bensim on G C. Surgical crown length ening procedure t o en hance esthet ics [ J ] . Int J P eriodontics Rest or ativne Dent ,1999, 19( 4) : 332～341
15.韩蔚,欧阳翔英,王新知,等.牙冠延长术的疗效及影响因素分析[ J ].中华口腔医学杂志, 2004, 39 (4) : 280– 283
16.欧阳翔英.有助于残根修复的牙冠延长术[J].中华口腔医学杂志, 2004, 39( 3) : 205～207
17.Bragger U , Lauchenauer D, Lang N P. Surgical length eningof the clini cal cr ow n [ J ] . J Clin Periodontol , 1992, 19 ( 1) :58～63.
18.曹采方.牙周病学[M] .北京:人民卫生出版社, 2003.67
19.欧阳翔英.有助于残根修复的牙冠延长术[J] .中华口腔医学杂志, 2004, 39(3):205- 206
20.KebirK,Martine H.周爽英,译.对临床短冠修复和牙周治疗的考虑[J].精粹中国口腔医学继续教育杂志,1999,2(4):38-42.
21.时淑红。烤瓷修复不同肩台位置对牙周影响的比较分析[J].实用医学杂志,2007,23(20):3281.
22.黄建生,周磊,宋光保,等.前牙临床短冠牙冠延长术后烤瓷修复的临床效果观察[J].实用口腔医学,2004,20(5):547-549.
23.白乐康,胡燕萍,安虹.牙列重度磨耗患者牙合重建设计与治疗.实用口腔医学杂志, 2001, 17( 5) : 434
24.陈丽霞.牙冠延长术结合桩核冠修复牙体缺损的临床应用[J].华夏医学, 2009,03(22):477～450
25.Dolt AH 3rd, Robbins JW. Altered passiv e er uption: An etiology of shor t clinical crowns. Quintessence Int, 1997, 28 ( 6) :362
26.Lannilgsk,Waldrop Tc, Gunsolley Jc, etal. surgical crown length 2 ening: Evaluation of the biologic width [ J ]. Periodontol, 2003, 74(4) : 468 - 474.
27.常少海,叶剑涛,刘东雄,等.成人佩戴固定矫治器对牙龈健康的影响———附48例报告[ J ].新医学, 2003, 34 (8) : 108
28.杨美祥,丁寅,徐如生.正畸治疗与牙周组织健康[J].牙体牙髓牙周病杂志, 1998,8(3): 224 - 225.
29.林久祥.正畸与牙周病[M ].北京:中国医药科技出版社,1990, 650.