Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun S Ave, Haidian District, Beijing, 100081, China.
Department of Restorative Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China.
BMC Oral Health. 2022 Mar 30;22(1):99. doi: 10.1186/s12903-022-02143-z.
Whether to preserve a structurally compromised tooth or remove it is a dilemma often encountered by clinicians. The aim of this study was to assess the long-term success rate of fractured teeth preserved by modified crown lengthening surgery and restorations.
Thirty-nine patients with a total of 45 fractured teeth who had received modified crown lengthening surgery were recruited and examined. Numbers of teeth lost were recorded, and the criteria for successful teeth were defined. Kaplan-Meier estimator was used to determine the success rate. Possible risk factors were compared between successful and unsuccessful groups by a Cox regression analysis to explore the potential predictors of failure with a significant level at α = 0.05.
The mean ± SD of success time without considering variants was 6.2 ± 0.6 years (95% CI 5.1-7.7). The mean survival rates ± SD at 1.0-, 2.0-, 3.0-, 5.0-, 7.0-, and 9.0-year intervals was 97.8 ± 2.2%, 92.2 ± 4.4%, 72.8 ± 7.9%, 68.2 ± 8.6%, 60.7 ± 10.5%, and 40.4 ± 13.6%, respectively. Failure cases in teeth with poor plaque control and step-shaped fracture margin were significantly more than those with good plaque control and knife-shaped fracture margin (HR = 7.237, p = 0.011; HR = 15.399, p = 0.006; respectively).
Fractured teeth treated with modified crown lengthening surgery are anticipated to have a high clinical success rate for 6.2 ± 0.6 years. Plaque control and fracture morphology appeared to be significantly associated with the success of the multidisciplinary treatment approach.
保留结构受损的牙齿还是将其拔除，这是临床医生经常面临的困境。本研究旨在评估经改良牙冠延长术后修复的折裂牙的长期成功率。
共招募并检查了 39 名患者的 45 颗折裂牙，这些患者均接受了改良牙冠延长术。记录失牙数量，并定义成功牙的标准。采用 Kaplan-Meier 估计法确定成功率。通过 Cox 回归分析比较成功组和失败组之间的可能风险因素，以探讨具有统计学意义（α=0.05）的失败预测因子。
不考虑变异时，平均成功时间为 6.2±0.6 年（95%CI 5.1-7.7）。1.0、2.0、3.0、5.0、7.0 和 9.0 年的平均生存率分别为 97.8±2.2%、92.2±4.4%、72.8±7.9%、68.2±8.6%、60.7±10.5%和 40.4±13.6%。菌斑控制差和阶梯状折裂缘的牙齿的失败病例明显多于菌斑控制良好和刀切状折裂缘的牙齿（HR=7.237，p=0.011；HR=15.399，p=0.006）。
经改良牙冠延长术治疗的折裂牙，预计在 6.2±0.6 年内有较高的临床成功率。菌斑控制和折裂形态与多学科治疗方法的成功显著相关。
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