2023年7月25日发(作者：)

口腔颌面修复学杂志2021年3月第22卷第2期CHINESEJOURNALOFPROSTHODONTICSMARCH2021VOL.22NO.2·论著·第二磨牙远中龈下缺损龈壁提升后高嵌体修复的短期临床观察*第二磨牙远中龈下缺损龈壁提升后高嵌体修复的短期临床观察*申林汪婷婷【摘要】目的:对龈壁提升术用于高嵌体修复第二磨牙远中龈下缺损的效果展开探讨，为临床应用给予借鉴。方法:选取65例存在远中龈下缺损表现的第二磨牙，根管治疗完善后用树脂行龈壁提升，使远中缺损的边缘提升至龈上后铸瓷高嵌体修复，基于改良USPHS标准于修复后1周、半年、1年时开展随访观察，对于边缘密合性、牙体完整性、修复体折裂、边缘着色、牙龈健康状况、修复体固位、继发龋7个方面分A、B、C三级评价临床效果，并于修复前、修复后6、12个月检测远中牙龈的出血指数（BI）和牙周探诊深度（PD）评价牙周状况。结果:65例患牙均无失访，术后1周在上述七方面均评价为A级。术后6个月，共62例评价为A级，有2例嵌体脱落，给予再次粘固随访至今未脱落，有1例牙龈轻度炎症，患者增强自洁后恢复健康。术后12个月，共59例评价为A级，成功率为90.8%，有2例嵌体崩瓷，2例牙龈轻度炎症，边缘密合性、牙体完整性、边缘着色、修复体固位、继发龋方面表现良好。治疗前与修复后6个月、12个月BI、PD值差异无统计学意义（P>0.05）。结论:对于远中龈下缺损的第二磨牙，龈壁提升术用于铸瓷高嵌体修复的临床成功率高、创伤小、操作简便、对牙周健康影响小，可以作为龈下缺损不破坏生物学宽度时替代冠延长术的一种选择。关键词:第二磨牙；龈下缺损；龈壁提升术；树脂；高嵌体［中国图书分类号］R782.2［文献标识码］ADOI:10.19748/.1009-3761.2021.02.002Short-termclinicalobservationoftheonlayrestorationsonthesecondmolarswithdistalsubgingivaldefectsafterdeepmarginelevationSHENLin,WANGTing-ting.(DepartmentofStomatology,BeijingFirstHospitalofIntegratedChineseandWesternMedicine,Beijing100026,China)【Abstract】Objective:Toevaluatetheeffectoftheonlayrestorationsonthesecondmolarswithdistalsubgingivaldefectsafters:Afterthecompletionofrootcanaltreatment,65casesofthesecondmolarwithdistalsubgingivaldefectsweretreatedwithresinfillingtoelevatethesubgingivalmargintothesuperiorgingivalmargin,1week,6monthsand12monthsaftertherestoration,thepatientswerefollowedupaccordingtothemodifiedUSPHScriteria,andtheclinicaleffectswereevaluatedinthreelevels:A,BandCforthefollowingsevenaspects:marginaltightness,dentalintegrity,restorationfracture,marginalstaining,gingivalhealth,ngindex(BI)andperiodontalprobedepth(PD)ofthedistalgingivalweremeasuredbeforetreatment,s:Noneofthe65patientslostfollow-up,andallofthemwereraonthsaftertheoperation,62patientswereratedasgradeA,andtwoonlaysweredetached,whichhavenosheddingsincethefollow-upofre-adhesion,andonepatienthadmildgingivalinflammation,vemonthsaftertheoperation,59caseswereratedasgradeA,withthesuccessrateof90.8%.Therewere2caseswithonlayporcelainfractureand2caseswithmildgingivalinflammation,whichshowedsatisfactoryeffectsinsuchaspectsasmarginaltightness,dentalintegrity,marginalstaining,asnosignificantdifferenceinBIandPDvaluesbeforetreatment,and6and12monthsaftertherestoration(P>0.05).Conclusion:Forthesecondmolarswithdistalsubgingivaldefects,deepmarginelevationhasahighclinicalsuccessrate,lesstrauma,simpleoperation