Góra Monika
Zakład Stomatologii Zachowawczej Katedry Stomatologii Zachowawczej i Periodontologii Pomorskiej Akademii Medycznej al. Powstańców Wlkp. 72, 70-111 Szczecin.
Ann Acad Med Stetin. 2005;51(1):57-63.
Hemisection is a surgical method for treating lesions of two- and multi-rooted teeth. This procedure includes amputation of one or two lesioned roots together with the attached dental crown, leaving an endodontically treated root and the remaining dental crown prepared for future prosthetic restoration. The results of this study demonstrate that HA Biocer implants create optimal conditions for new bone growth.
The study was done in 51 patients after hemisection treated with HA Biocer in the form of granules implanted into the alveolus. The control group consisted of 45 patients without an alloplastic implant. The following indices were assessed: radiological index of alveolar bone atrophy in the maxilla and mandible according to Engelberger, Marthaler and Rateischak [EMR]; gingival pocket depth with WHO 621 probe; tooth mobility index according to Entin; root denudation index according to Cieszyfiski; bacterial plaque index (P1.1.) according to Silness and Löe. Measurements were done before hemisection and were repeated after 1.5, 6, 12, 24, 36, 48, and 60 months thereafter. It was found that hydroxyapatite implants improved the condition of the hemisected tooth and arrested the destruction process in the alveolar bone.
(1) In the study group (HA Biocer), no bone atrophy was noted in the root region after hemisection, whereas bone loss in the control group reached 11%. (2) The depth of gingival pockets in the study group was half of the depth in the control group. (3) Significant tooth stabilization was achieved in the study group, mainly during the first two years after implantation. Improved tooth stability was noted three times less often in the control group during the same period. (4) Root denudation diminished in patients treated with HA Biocer and increased or remained unchanged in controls. (5) A steady decrease in mean P1.1. index values was observed in both groups over the five-year follow-up period. However, the mean P1.1. value in the study group was one-third of the value in the control group.
半切术是治疗双根牙和多根牙病变的一种手术方法。该手术包括将一个或两个病变牙根连同附着的牙冠切除，保留一个经过根管治疗的牙根以及为未来修复准备的剩余牙冠。本研究结果表明，羟基磷灰石生物陶瓷植入物为新骨生长创造了最佳条件。
本研究对51例接受半切术并用颗粒状羟基磷灰石生物陶瓷植入牙槽窝治疗的患者进行。对照组由45例未使用异体植入物的患者组成。评估了以下指标：根据恩格尔伯格、马尔塔勒和拉泰施卡[EMR]的方法评估上颌和下颌牙槽骨萎缩的放射学指标；使用世界卫生组织621型探针测量牙龈袋深度；根据恩廷的方法评估牙齿松动指数；根据切申斯基的方法评估牙根暴露指数；根据西尔尼斯和勒的方法评估菌斑指数（P1.1.）。测量在半切术前进行，并在术后1.5、6、12、24、36、48和60个月重复进行。结果发现，羟基磷灰石植入物改善了半切牙的状况，并阻止了牙槽骨的破坏过程。
（1）研究组（羟基磷灰石生物陶瓷组）半切术后牙根区域未观察到骨萎缩，而对照组骨丢失达11%。（2）研究组牙龈袋深度为对照组的一半。（3）研究组实现了显著的牙齿稳定，主要是在植入后的头两年。同期对照组牙齿稳定性改善的情况仅为研究组的三分之一。（4）接受羟基磷灰石生物陶瓷治疗的患者牙根暴露减少，而对照组牙根暴露增加或保持不变。（5）在五年随访期内，两组的平均P1.1.指数值均稳步下降。然而，研究组的平均P1.1.值仅为对照组的三分之一。
