牙冠延长术在残根保存修复中的应用

发布时间：2018-07-02 07:46

本文选题：牙冠延长术 + 残根　；参考：《大连医科大学》2016年硕士论文

【摘要】：目的:通过对残根采用牙冠延长术的临床保存修复效果观察,为残根的保存及修复提供较为合理的治疗方案,以提高残根的保存率。方法:选取2014年6月~2015年10月因残根及牙列缺损来我科就诊要求修复的患者30例,共32颗残根(前牙10颗,前磨牙8颗,磨牙14颗)。其中男性18位,20颗牙;女性12位,12颗牙;年龄22~64岁,平均年龄43岁,所有患牙均符合保存要求。在征得患者知情同意后签订同意书,32颗患牙经过完善的根管治疗1~2周后,患者无自觉症状,无叩痛,局麻下使用手术刀法、高频电刀法配合高速手机施行牙冠延长术,术后6周开始行桩核冠、联冠、固定桥、覆盖义齿、附着体义齿等修复。随访观察3~16个月,采用成功,欠佳,失败判断其疗效。成功:患者无自觉症状,修复体边缘密合,固位良好,牙龈健康,龈缘与邻牙协调,无牙周袋,患牙无松动,牙槽骨无吸收,美观效果患者满意。欠佳:牙龈颜色正常,修复体固位良好,边缘略暴露,牙槽骨有轻微吸收,患者较满意。失败:牙龈红肿或退缩,修复体边缘暴露明显,修复体松动或脱落,牙槽骨明显吸收,患者不太满意。结果:32颗患牙,经根管治疗及牙冠延长术后行桩核冠、联冠、固定桥等修复,32颗患牙中29颗成功,表现为患者无自觉症状,修复体边缘密合,固位良好,牙龈健康,龈缘与邻牙协调,无牙周袋,患牙无松动,牙槽骨无吸收,成功率达90.63%。1颗欠佳,为上切牙,行修复后呈现“黑三角”,拆除重新制作后美观效果改善,另有2颗患牙失败,其中1颗患牙修复后12个月,因咬合创伤修复体松动脱落,牙根I°松动,X线示牙槽骨吸收,经调牙合后重新粘回后逐渐恢复;另1颗患牙修复2个月后出现牙龈边缘红肿,并向牙冠方向增生超过1mm,X线示牙周膜间隙增宽,处置方法将修复体拆除,待恢复后重新行牙冠延长术并修复此患牙。结论:残根在掌握好适应症的前提下,使用牙冠延长术后再行修复的方法,可以达到恢复美观及咀嚼功能,延长残根使用寿命,防止牙槽骨吸收的目的。
[Abstract]:Objective: To observe the clinical preservation and repair effect of crown lengthening for residual root, provide a reasonable treatment scheme for the preservation and repair of residual root, in order to improve the preservation rate of residual root. Methods: 30 patients with 32 remnant roots (10 anterior teeth, anterior teeth, anterior teeth) were selected to be repaired in October, June 2014, due to the residual root and dentition defect. There were 8 molars and 14 molars. Among them, there were 18 men and 20 teeth, 12 women and 12 teeth. The age was 22~64 years old, the average age was 43 years old. All the affected teeth were conformed to the requirements of preservation. After the patient's informed consent, the consent was signed and the patients were treated with perfect root canal for 1~2 weeks. The patients had no conscious symptoms, no percussion pain, operation knife method under local anesthesia, high frequency. Electric knife method combined with high speed mobile phone to perform crown lengthening. After 6 weeks, post coronal crown, combined crown, fixed bridge, overdenture and attachment denture were repaired. Follow up and observe 3~16 months, use successful, poor, failure to judge its curative effect. No periodontal pocket, no loose teeth, alveolar bone no absorption, beautiful effect of patients satisfaction. Poor: normal color of the gums, repair body solid position, edge slightly exposed, alveolar bone slight absorption, the patient is more satisfied. Failure: gums red swelling or shrink, repair body edge exposure, prosthesis loosening or fall, alveolar bone absorption obviously, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full Results: 32 teeth, after root canal therapy and crown lengthening, were repaired with pile core crown, combined crown, fixed bridge and other restorations. 29 of 32 teeth were successful, showing that the patients had no conscious symptoms, repaired body edge close, solid position, healthy gingiva, gingival margin and adjacent teeth, no periodontal pocket, teeth loosening, alveolar bone no absorption, the success rate reached 90.63%.1 due. Good, for upper incisors, after the repair of the "black triangle", after the removal of the reconstruction of the aesthetic effect improved, and 2 other teeth failed, of which 1 teeth were repaired 12 months after the restoration of trauma, the root of the tooth loosening, root I degree loosening, X-ray show alveolar bone absorption, after the tooth recombined back to restore gradually; the other 1 teeth to repair 2 months after the restoration. The edge of the gums is red and swollen, and the growth of the crown direction is more than 1mm. The X - ray shows the widening of the periodontal ligament space. The treatment method will remove the prosthesis. After the restoration, the tooth crown lengthening and repairing the tooth. Conclusion: the residual root can be restored to beauty and chewing with the method of dental crown lengthening. Function, prolonging the life of residual roots and preventing alveolar bone absorption.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R783.3

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