Huang Di, Luo Liwen, Lan Xu
Department of Stomatology, Ganzhou People's Hospital Ganzhou 341000, Jiangxi, China.
Am J Transl Res. 2023 Jul 15;15(7):4649-4657. eCollection 2023.
The appearance of the gingival tissue around the teeth is essential in the aesthetics of the anterior maxillary region of the oral cavity. Abnormalities in symmetry and contour can significantly compromise the appearance of the natural or restored dentition, so the outcome is highly relevant to treatment choice. This study evaluated the efficacy of crown lengthening for restoration of maxillary anterior tooth defects.
A total of 80 patients (87 affected teeth) diagnosed with maxillary anterior tooth loss in Ganzhou People's Hospital between May 2020 and August 2021 were retrospectively enrolled and divided into an experimental group or a reference group according to different treatment methods, with 40 cases in each group. The reference group received a post and core procedure, while the experimental group received crown lengthening plus a post and core procedure. Outcome measures included clinical efficacy, gingival periodontal-related indices, and dental aesthetics indices.
Crown lengthening plus post and core procedure was associated with a significantly higher clinical efficacy (95.65%) versus post and core procedure alone (78.05%) (P<0.05). Postoperatively, the levels of probing depth (PD), plaque index (PLI), bleeding index (BI), and gingival index (GI) were lower in patients of the experimental group than those in the reference group (all P<0.05). Crown lengthening plus post and core procedure resulted in more Kay class I and II patients and fewer Kay class III and IV versus the post and core procedure alone (P<0.05). The position of gingival margin (PGM) and gingival recession (GR) of patients in the experimental group were higher than those in the reference group after operation (P<0.05). Logistic regression analysis showed that the morphology of broken ends, plaque control, hygiene habits, and smoking were influencing factors for maxillary anterior tooth defects (all P<0.05). Patients were more satisfied (97.50%) in the experimental group than those in the reference group (80.00%) (P<0.05).
Crown lengthening improves the periodontal condition of patients with maxillary anterior tooth loss, reduces gingival sulcus bleeding, and improves dental aesthetics and patient satisfaction. Further clinical studies are required prior to clinical promotion.
牙齿周围牙龈组织的外观对口腔上颌前部区域的美观至关重要。对称性和轮廓异常会显著影响天然牙列或修复牙列的外观，因此其结果与治疗选择高度相关。本研究评估了牙冠延长术修复上颌前牙缺损的疗效。
回顾性纳入2020年5月至2021年8月在赣州市人民医院诊断为上颌前牙缺失的80例患者（87颗患牙），根据不同治疗方法分为实验组和参照组，每组40例。参照组接受桩核修复，实验组接受牙冠延长术联合桩核修复。观察指标包括临床疗效、牙龈牙周相关指标和牙齿美观指标。
牙冠延长术联合桩核修复的临床疗效（95.65%）显著高于单纯桩核修复（78.05%）（P<0.05）。术后，实验组患者的探诊深度（PD）、菌斑指数（PLI）、出血指数（BI）和牙龈指数（GI）水平均低于参照组（均P<0.05）。与单纯桩核修复相比，牙冠延长术联合桩核修复术后Kay I类和II类患者更多，III类和IV类患者更少（P<0.05）。术后实验组患者的龈缘位置（PGM）和牙龈退缩（GR）高于参照组（P<0.05）。Logistic回归分析显示，断端形态、菌斑控制、卫生习惯和吸烟是上颌前牙缺损的影响因素（均P<0.05）。实验组患者的满意度（97.50%）高于参照组（80.00%）（P<0.05）。
牙冠延长术可改善上颌前牙缺失患者的牙周状况，减少牙龈沟出血，提高牙齿美观度和患者满意度。在临床推广之前还需要进一步的临床研究。
