中国实用口腔科杂志

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美学区基牙根尖病变冠桥再修复短期疗效观察

吴王喜a陈筑苏b,周    磊b,邱钧琦a   

  1. 南方医科大学附属口腔医院·广东省口腔医院a种植中心,b牙体牙髓科,广州  510280  
  • 出版日期:2015-07-15 发布日期:2015-07-22
  • 基金资助:

    广东省医学科学技术研究基金立项课题(A2013095)

  • Online:2015-07-15 Published:2015-07-22

摘要:

目的    观察上颌前牙区冠桥修复继发根尖周病变患者,进行根尖外科手术同期联合冠延长术后冠桥再修复的短期治疗效果。方法     选择2013年9月至2014年10月广东省口腔医院门诊就诊的上颌前牙区冠桥修复后继发根尖周病患者6例,病灶局部行根尖外科手术(根尖刮治、根尖切除及根尖倒充填),同期采用冠延长术增加基牙临床冠高度,修整龈缘及牙槽嵴外形,术前术后暂时修复体成型牙龈,术后3个月软硬组织改建稳定,进行纤维桩树脂核、二硅酸锂铸瓷永久冠修复。每一治疗阶段采用锥形束CT(CBCT)评估骨组织愈合情况,红色美学评分(pink esthetics score,PES)评价软组织转归情况。结果    根尖周病灶骨缺损区新骨充填,修复体周龈缘形态稳定,质地色泽协调,修复体正常行使功能。结论    根尖外科手术同期冠延长术治疗冠桥修复继发根尖周病临床可行,每阶段暂时修复体有利于再修复最终修复体的美学效果。

关键词: 美学, 暂时性修复体, 根尖手术, 冠延长术, 根尖周病变

Abstract:

Objective    To evaluate the one stage procedures of apical surgery with crown lengthening and the second restoration for upper anterior teeth with apical diseases and compromised fixed prosthesis in short-term. Methods    Totally 6 patients with severe periapical diseases and compromised prosthesis,from Guangdong Provincial Stomatological Hospital between Sep. 2013 to Oct. 2014,were treated using simultaneous apical surgery with crown lengthening for periapical curettage,resecting apical lesion,retrograding filling trimming gingival margin,shaping alveolar,improving clinical crown height,provisional restorations before and after surgeries,then final restorations by fiber-resin posts and cores and lithium disilicate crowns 3 months after surgeries. Evaluation of modeling and remodeling was made by CBCT,soft tissue re-building by PES. Results    Periapical defect was filled with new bone,and gingival margins and restorations were stable 6 months after surgeries with harmonious color and normal function. Conclusion    Simultaneous apical surgery and crown lengthening is an effective treatment for upper anterior teeth with periapical diseases and compromised prosthesis;final esthetic is facilitated by provisional restorations. 

Key words: esthetic, provisional restoration, apical surgery, crown lengthening, periapical diseases