北京大学学报(医学版) ›› 2014, Vol. 46 ›› Issue (5): 727-732.

• 论著 • 上一篇    下一篇

锥束CT评价下颌磨牙根分叉病变再生治疗疗效

乔静-1, 段晋瑜-1, 孙昌洲-1△, 柳登高-2   

  1. (1.北京大学口腔医学院·口腔医院第一门诊部,北京 100034;2. 北京大学口腔医学院·口腔医院放射科,北京 100081)
  • 出版日期:2014-10-18 发布日期:2014-10-18

Effect of regenerative therapy for the furcation involvements of mandibular molars evaluated by cone-beam computed tomography

QIAO Jing1, DUAN Jin-yu1, SUN Chang-zhou1△, LIU Deng-gao2   

  1. (1. The First Outpatient Center, Peking University School and Hospital of Stomatology, Beijing 100034, China; 2. Department of Oral Radiology, Peking University School and Hospital of Stomatology, Beijing 100081, China)
  • Online:2014-10-18 Published:2014-10-18

摘要: 目的:利用锥束计算机体层摄影术(cone-beam computed tomography,CBCT)分析和评价下颌磨牙根分叉病变再生治疗的疗效。方法:纳入需进行牙周手术的38例下颌磨牙根分叉病变,随机分为2组,实验组采用引导性组织再生术+植骨术进行治疗,对照组进行单纯翻瓣术。在术前和术后1年时分别对患牙进行临床检查,并拍摄CBCT。比较实验组和对照组各自手术前后临床数据和CBCT数据的变化,并比较两组数据变化间的差别。结果:基线时两组的探诊深度、垂直向附着丧失和水平向附着丧失差异均无统计学意义(P>0.05)。术后1年时,除牙龈退缩外,两组临床指标均有显著改善(P<0.001),但实验组垂直向附着获得和水平向附着获得分别为(3.20±1.82) mm和(2.05±1.27) mm,显著高于对照组相应指标的变化(P<0.001)。基线时两组CBCT显示的水平骨丧失、垂直骨丧失差异均无统计学意义(P>0.05);术后1年时,实验组垂直向骨缺损和水平向骨缺损较基线时和对照组均有显著改善(P<0.001),分别减少(2.82±0.97) mm和(2.24±0.92) mm。结论:引导性组织再生术+植骨术对于下颌磨牙Ⅱ度根分叉病变的治疗效果显著优于翻瓣术,CBCT可以较好地反映下颌磨牙根分叉区域的水平向和垂直向的骨缺损改善情况,较为全面地补充临床检查和传统X线根尖片的不足。

关键词: 锥束计算机体层摄影术, 根分叉部缺损, 牙周再生

Abstract: Objective:To evaluate the effect of regenerative therapy for the treatment of furcation involvements of mandibular molars with cone-beam computed tomography (CBCT). Methods: In the study, 38 furcation involvements of mandibular molars were included and randomly divided into two groups. The experimental group accepted guided tissue regeneration and bone graft therapy, and the control group only flap surgery. The clinical examination and CBCT examination were performed at baseline and 1 year post-surgery. Results: The clinical and CBCT data of both groups were not statistically different at baseline (P>0.05). At the end of 1 year post-surgery, except gingival recession, the clinical parameters of both groups were significantly improved (P<0.001). The vertical and horizontal attachment gains of the experimental group were (3.20±1.82) mm and (2.05±1.27) mm, respectively, and significantly higher than the changes of the control group (P<0.001). And at the end of 1 year post-surgery, the experimental group showed significantly higher bone gain at the vertical and horizontal directions compared with those of the control group: (2.82±0.97) mm and (2.24±0.92) mm, respectively (P<0.001). Conclusion: With the limitation of this study, the effect of guided tissue regeneration surgery and bone graft therapy for the treatment of furcation involvements of mandibular molars is significantly better than that of the flap surgery. CBCT can reflect the horizontal and vertical bone changes of furcation area, which is more comprehensive than traditional periapicals.

Key words: Cone-beam computed tomography, Furcation defects, Periodontal regeneration

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