Pham Hien Tin, Nguyen Phuc Anh, Pham Thuy Anh Vu
Department of Periodontology, National Hospital of Odonto-Stomatology, Ho Chi Minh City, Vietnam.
Faculty of Odonto-Stomatology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
Dent Traumatol. 2018 Dec;34(6):455-463. doi: 10.1111/edt.12438. Epub 2018 Oct 16.
BACKGROUND/AIMS: The number of fractured anterior teeth following trauma has been increasing while not every patient is able to afford a dental implant instead of maintaining the injured tooth. Thus, a tooth conservation solution is required to place an aesthetic and functional restoration without biologic width violation. The aim of this study was to evaluate the effectiveness of minimally traumatic controlled surgical extrusion in fractured anterior teeth crown lengthening by assessing the periodontal status through clinical examination and radiographs.
This longitudinal observational study investigated a group of 18 patients (six males and 12 females) at the Department of Periodontology, National Hospital of Odonto-stomatology, Ho Chi Minh City, Vietnam. Following pre-surgery procedures and examination, minimally traumatic controlled surgical extrusion was carried out using a periotome. Patients were examined at four follow-up appointments after 1 week, 1, 3 and 6 months to record the following experimental variables: periodontal parameters including the gingival index (GI), pocket depth (PD), bleeding on probing (BOP), mobility, marginal gingiva position, alveolar ridge resorption, periapical osteogenesis, tooth resorption and ankylosis.
All periodontal parameters were significantly decreased at 3 and 6 months post-procedure (P < 0.001). Tooth mobility decreased gradually following surgery, and at 6 months, all teeth became normal at level 0. Periapical osteogenesis changes were significantly increased at 1, 3 and 6 months in comparison with pre-surgery (P < 0.001). Marginal gingiva position and alveolar ridge resorption were not significantly different between pre-surgery and 1, 3 and 6 months post-surgery. No cases of root resorption or ankylosis were observed at 6 months post-surgery.
A minimally traumatic controlled surgical extrusion technique for clinical crown lengthening yielded highly successful results in both aesthetic and functional aspects, and no cases had unfavourable outcomes during the 6-month follow-up period.
背景/目的：外伤后前牙折断的数量一直在增加，然而并非每个患者都能负担得起种植牙而选择保留受伤牙齿。因此，需要一种牙齿保存解决方案，以在不侵犯生物学宽度的情况下进行美观且功能良好的修复。本研究的目的是通过临床检查和X线片评估牙周状况，以评价微创控制手术挤压术在前牙折断牙冠延长术中的有效性。
这项纵向观察性研究在越南胡志明市国家口腔医院牙周病科对18例患者（6例男性和12例女性）进行了调查。在进行术前程序和检查后，使用牙周刀进行微创控制手术挤压术。在术后1周、1、3和6个月进行4次随访检查，记录以下实验变量：牙周参数，包括牙龈指数（GI）、牙周袋深度（PD）、探诊出血（BOP）、牙齿松动度、边缘龈位置、牙槽嵴吸收、根尖成骨、牙根吸收和牙 ankylosis。
术后3个月和6个月时，所有牙周参数均显著降低（P < 0.001）。术后牙齿松动度逐渐降低，6个月时，所有牙齿均恢复至0度正常松动度。与术前相比，术后1、3和6个月根尖成骨变化显著增加（P < 0.001）。术前与术后1、3和6个月的边缘龈位置和牙槽嵴吸收无显著差异。术后6个月未观察到牙根吸收或牙 ankylosis 病例。
用于临床牙冠延长的微创控制手术挤压技术在美观和功能方面均取得了非常成功的结果，并且在6个月的随访期内没有出现不良结果。
