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根分叉病变牙齿的治疗。一项回顾性分析。

Management of furcation-involved teeth. A retrospective analysis.

作者信息

Müller H P, Eger T, Lange D E

机构信息

Department of Operative Dentistry and Periodontology, University of Heidelberg, Germany.

出版信息

J Clin Periodontol. 1995 Dec;22(12):911-7. doi: 10.1111/j.1600-051x.1995.tb01794.x.

Abstract

In the present study, data from more than 550 periodontally diseased patients with more than 1100 furcation invasions were retrospectively analysed. There were apparent differences in the distribution of different furcation degrees in patient populations treated by 2 differently experienced operators. However, treatment modality patterns were rather similar. Scaling during periodontal flap surgery was the most often performed treatment procedure in degree I (97-98%) and II (75-83%) involvements. About 44% of degree III involved teeth were extracted. In order to determine the influence of degree of furcation involvement, tooth type and operator variability on treatment modality, logistic regression analysis was applied. Degree of furcation involvement was an important indicator variable in all models. Scaling as a sole measure was mainly performed in relation to degree I of furcation involvement. With every increase in degree, the odds of scaling decreased by factor 12.7. The odds of root resection was upper 1st molars 46 x higher than in wisdom teeth or lower 2nd molars with the same degree of involvement, but only 3.3 x higher than in lower 1st molars. Tunnel preparation as well as regenerative procedures were mainly confirmed to lower molars. Operator variability was only introduced as a covariate in the extraction model. hence, despite of different operator skill and severity of periodontal disease in treated populations, decision for one or the other treatment modality seems to depend essentially on degree of furcation involvement as well as tooth type.

摘要

在本研究中,对550多名患有牙周病且有1100多处根分叉病变的患者的数据进行了回顾性分析。在由两位经验不同的操作者治疗的患者群体中,不同根分叉程度的分布存在明显差异。然而,治疗方式模式相当相似。在I度(97 - 98%)和II度(75 - 83%)根分叉病变中,牙周翻瓣手术时的刮治是最常进行的治疗程序。III度根分叉病变的牙齿中约44%被拔除。为了确定根分叉病变程度、牙齿类型和操作者差异对治疗方式的影响,应用了逻辑回归分析。根分叉病变程度在所有模型中都是一个重要的指标变量。单纯刮治主要针对I度根分叉病变进行。随着程度的每增加一级,刮治的几率降低12.7倍。在相同病变程度下,上颌第一磨牙进行根切术的几率比智齿或下颌第二磨牙高46倍,但仅比下颌第一磨牙高3.3倍。隧道制备以及再生手术主要针对下颌磨牙进行。操作者差异仅作为提取模型中的一个协变量引入。因此,尽管治疗人群中操作者技能和牙周病严重程度不同,但选择一种或另一种治疗方式似乎主要取决于根分叉病变程度以及牙齿类型。

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