Wang C, Jia X T, Hu W J, Zhen M, Zhang H
Department of Periodontology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2017 Mar 9;52(3):182-187. doi: 10.3760/cma.j.issn.1002-0098.2017.03.011.
To observe the long-term clinical treatment outcome and the influencing factors of the outcome for the teeth receiving modified crown lengthening surgery combined with root canal treatment and post-core crown restoration. To summarize the clinical guidelines of modified crown lengthening surgery in selection of indications and for mulation of treatment planning. Fifty-seven patients with a total of 67 teeth receiving modified crown lengthening surgery combined with root canal treatment and post-core crown restoration for at least a 6 months' follow-up period between July 2004 and July 2013 were recruited in this retrospective study by phone call interviews. The patients' clinical outcomes were evaluated by the combination of clinical examination, radiograph and questionnaire regarding patient-reported outcome of the last follow up (≥9 months post modified crown lengthening surgery and ≥6 months after definite crown restorations). All of the treated teeth were classified into two groups, group A (teeth with good clinical treatment outcome) and group B (teeth with poor clinical treatment outcome), based on the defined criteria including patients' satisfaction with the function and esthetics of the teeth and absence of periodontal, endodontic and prosthodontic complications. The potential influencing factors of clinical treatment outcome were also determined by Logistic regression analysis. Vertical root fracture in 1 tooth was found on its periapical film and the tooth was deemed hopeless. Thus, the survival rate is 99% (66/67) for the multidisciplinary treatment approach. Seventy-two percent (48/67) of the teeth achieved good clinical treatment outcome and 28% (19/67) of the teeth developed one or several complications. In group B (teeth with poor clinical treatment), 16 out of teeth exhibited periodontal complications with bleeding on probing (BOP) positive mostly found. Logistic regression analysis demonstrated that plaque control (21.392, 0.014), edge form (7.610, 0.011), and smoking experience (7.315, 0.018) were the risk factors influencing the clinical treatment outcome of modified crown lengthening surgery combined with root canal treatment and post-core restoration. Modified crown lengthening surgery combined with root canal treatment and post-core restoration has a good and stable clinical effect in the observational time of 6-114 months. Plaque control, smoking status and edge form of the tooth appeared to be the influencing factors of this multidisciplinary treatment approach.
观察接受改良牙冠延长术联合根管治疗及桩核冠修复的牙齿的长期临床治疗效果及影响该效果的因素。总结改良牙冠延长术在适应证选择及治疗计划制定方面的临床指南。通过电话访谈，对2004年7月至2013年7月期间接受改良牙冠延长术联合根管治疗及桩核冠修复且至少随访6个月的57例患者共67颗牙齿进行了这项回顾性研究。通过临床检查、影像学检查以及关于患者对最后一次随访（改良牙冠延长术后≥9个月且确定牙冠修复后≥6个月）的患者报告结局的问卷相结合的方式，对患者的临床结局进行评估。根据包括患者对牙齿功能和美观的满意度以及不存在牙周、牙髓和修复并发症等既定标准，将所有治疗的牙齿分为两组，A组（临床治疗效果良好的牙齿）和B组（临床治疗效果不佳的牙齿）。还通过Logistic回归分析确定了临床治疗效果的潜在影响因素。在根尖片上发现1颗牙齿存在垂直根折，该牙齿被判定无法保留。因此，多学科治疗方法的成功率为99%（66/67）。72%（48/67）的牙齿获得了良好的临床治疗效果，28%（19/67）的牙齿出现了一种或几种并发症。在B组（临床治疗效果不佳的牙齿）中，16颗牙齿表现出牙周并发症，主要表现为探诊出血（BOP）阳性。Logistic回归分析表明，菌斑控制（21.392，0.014）、边缘形态（7.610，0.011）和吸烟史（7.315，0.018）是影响改良牙冠延长术联合根管治疗及桩核修复临床治疗效果的危险因素。改良牙冠延长术联合根管治疗及桩核修复在6至114个月的观察期内具有良好且稳定的临床效果。菌斑控制、吸烟状况和牙齿边缘形态似乎是这种多学科治疗方法的影响因素。
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