本文選題：牙冠延長術(shù) + 殘根　； 參考：《大連醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:通過對殘根采用牙冠延長術(shù)的臨床保存修復(fù)效果觀察,為殘根的保存及修復(fù)提供較為合理的治療方案,以提高殘根的保存率。方法:選取2014年6月~2015年10月因殘根及牙列缺損來我科就診要求修復(fù)的患者30例,共32顆殘根(前牙10顆,前磨牙8顆,磨牙14顆)。其中男性18位,20顆牙;女性12位,12顆牙;年齡22~64歲,平均年齡43歲,所有患牙均符合保存要求。在征得患者知情同意后簽訂同意書,32顆患牙經(jīng)過完善的根管治療1~2周后,患者無自覺癥狀,無叩痛,局麻下使用手術(shù)刀法、高頻電刀法配合高速手機(jī)施行牙冠延長術(shù),術(shù)后6周開始行樁核冠、聯(lián)冠、固定橋、覆蓋義齒、附著體義齒等修復(fù)。隨訪觀察3~16個月,采用成功,欠佳,失敗判斷其療效。成功:患者無自覺癥狀,修復(fù)體邊緣密合,固位良好,牙齦健康,齦緣與鄰牙協(xié)調(diào),無牙周袋,患牙無松動,牙槽骨無吸收,美觀效果患者滿意。欠佳:牙齦顏色正常,修復(fù)體固位良好,邊緣略暴露,牙槽骨有輕微吸收,患者較滿意。失敗:牙齦紅腫或退縮,修復(fù)體邊緣暴露明顯,修復(fù)體松動或脫落,牙槽骨明顯吸收,患者不太滿意。結(jié)果:32顆患牙,經(jīng)根管治療及牙冠延長術(shù)后行樁核冠、聯(lián)冠、固定橋等修復(fù),32顆患牙中29顆成功,表現(xiàn)為患者無自覺癥狀,修復(fù)體邊緣密合,固位良好,牙齦健康,齦緣與鄰牙協(xié)調(diào),無牙周袋,患牙無松動,牙槽骨無吸收,成功率達(dá)90.63%。1顆欠佳,為上切牙,行修復(fù)后呈現(xiàn)“黑三角”,拆除重新制作后美觀效果改善,另有2顆患牙失敗,其中1顆患牙修復(fù)后12個月,因咬合創(chuàng)傷修復(fù)體松動脫落,牙根I°松動,X線示牙槽骨吸收,經(jīng)調(diào)牙合后重新粘回后逐漸恢復(fù);另1顆患牙修復(fù)2個月后出現(xiàn)牙齦邊緣紅腫,并向牙冠方向增生超過1mm,X線示牙周膜間隙增寬,處置方法將修復(fù)體拆除,待恢復(fù)后重新行牙冠延長術(shù)并修復(fù)此患牙。結(jié)論:殘根在掌握好適應(yīng)癥的前提下,使用牙冠延長術(shù)后再行修復(fù)的方法,可以達(dá)到恢復(fù)美觀及咀嚼功能,延長殘根使用壽命,防止牙槽骨吸收的目的。
[Abstract]:Objective: To observe the clinical preservation and repair effect of crown lengthening for residual root, provide a reasonable treatment scheme for the preservation and repair of residual root, in order to improve the preservation rate of residual root. Methods: 30 patients with 32 remnant roots (10 anterior teeth, anterior teeth, anterior teeth) were selected to be repaired in October, June 2014, due to the residual root and dentition defect. There were 8 molars and 14 molars. Among them, there were 18 men and 20 teeth, 12 women and 12 teeth. The age was 22~64 years old, the average age was 43 years old. All the affected teeth were conformed to the requirements of preservation. After the patient's informed consent, the consent was signed and the patients were treated with perfect root canal for 1~2 weeks. The patients had no conscious symptoms, no percussion pain, operation knife method under local anesthesia, high frequency. Electric knife method combined with high speed mobile phone to perform crown lengthening. After 6 weeks, post coronal crown, combined crown, fixed bridge, overdenture and attachment denture were repaired. Follow up and observe 3~16 months, use successful, poor, failure to judge its curative effect. No periodontal pocket, no loose teeth, alveolar bone no absorption, beautiful effect of patients satisfaction. Poor: normal color of the gums, repair body solid position, edge slightly exposed, alveolar bone slight absorption, the patient is more satisfied. Failure: gums red swelling or shrink, repair body edge exposure, prosthesis loosening or fall, alveolar bone absorption obviously, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full, patients are not too full Results: 32 teeth, after root canal therapy and crown lengthening, were repaired with pile core crown, combined crown, fixed bridge and other restorations. 29 of 32 teeth were successful, showing that the patients had no conscious symptoms, repaired body edge close, solid position, healthy gingiva, gingival margin and adjacent teeth, no periodontal pocket, teeth loosening, alveolar bone no absorption, the success rate reached 90.63%.1 due. Good, for upper incisors, after the repair of the "black triangle", after the removal of the reconstruction of the aesthetic effect improved, and 2 other teeth failed, of which 1 teeth were repaired 12 months after the restoration of trauma, the root of the tooth loosening, root I degree loosening, X-ray show alveolar bone absorption, after the tooth recombined back to restore gradually; the other 1 teeth to repair 2 months after the restoration. The edge of the gums is red and swollen, and the growth of the crown direction is more than 1mm. The X - ray shows the widening of the periodontal ligament space. The treatment method will remove the prosthesis. After the restoration, the tooth crown lengthening and repairing the tooth. Conclusion: the residual root can be restored to beauty and chewing with the method of dental crown lengthening. Function, prolonging the life of residual roots and preventing alveolar bone absorption.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R783.3

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