申庸凡 徐薇 张超 路立花 王超

[摘要]目的：研究牙半切除術联合固定桥修复对重度根分叉病变患者咀嚼功能的影响。方法：随机选取2015年1月-2016年12月笔者医院收治的重度根分叉病变患者50例，均行牙半切除术联合固定桥修复治疗。评价患者治疗前后牙周指标、咬合状况、咀嚼功能、生活质量，观察临床疗效并作随访，统计复发率。结果：治疗后患者PLI、mBI、PD、HPD、AL、OT、BFDB、前牙覆盖、前牙咬合、探诊出血率均低于治疗前，MABF/MMF、咀嚼效率、咀嚼能力、积极感受、美观程度、总体健康评分高于治疗前，具有统计学意义（P<0.05）;治疗后3个月，患者PLI、mBI、PD、HPD、AL、OT、BFDB、前牙覆盖、前牙咬合、探针出血率均低于治疗后24h，MABF/MMF、咀嚼效率、咀嚼能力、积极感受、美观程度、总体健康评分高于治疗后24h，具有统计学意义（P<0.05）。患者咀嚼效率恢复时间为（19.48±1.12）d。50例患者，治疗失败2例，治疗成功48例，治疗成功率96.00%，对患者进行随访，无复发病例发生。结论：牙半切除术联合固定桥修复应用于重度根分叉病变治疗中，可显著改善患者牙周病变，促进患者咀嚼功能的恢复，提高生活质量，治疗效果显著，值得在临床上推广应用。

[关键词]牙半切除术;固定桥修复;重度根分叉病变;咀嚼功能;生活质量

[中图分类号]R783.4    [文献标志码]A    [文章编号]1008-6455（2021）03-0131-04

Effect of Dental Hemisection Combined with Fixed Bridge Restoration on Masticatory Function in Patients with Severe Bifurcation Disease

SHEN Yong-fan1， XU Wei2， ZHANG Chao1， LU Li-hua1， WANG Chao1

（1.Department of Prosthodontics， Hebei Eye Hospital， Xingtai 054000， Hebei，China; 2. Department of Stomatology， Renze District People's Hospital， Xingtai City，Xingtai 054000， Hebei，China）

Abstract：Objective  To study the effect of dental hemisection combined with fixed bridge restoration on masticatory function in patients with severe bifurcation lesions. Methods  From January 2015 to December 2016， 50 patients with severe bifurcation lesions were randomly selected. All patients underwent dental hemisection combined with fixed bridge prosthesis. The periodontal index，occlusal status， masticatory function and quality of life were evaluated before and after treatment. The clinical efficacy was evaluated and the recurrence rate was counted. Results After treatment， PLI， mBI， PD， HPD， AL， OT， BFDB， anterior teeth coverage， anterior teeth occlusion， probe bleeding rate were lower than those before treatment. MABF/MMF， masticatory efficiency， masticatory ability， positive feeling， aesthetic degree and overall health score were higher than those before treatment， with statistical differences （P<0.05）. PD， HPD， AL， OT， BFDB， anterior teeth coverage， anterior teeth occlusion， probe bleeding rate were lower than 24 hours after treatment. MABF/MMF， masticatory efficiency， masticatory ability， positive feeling， aesthetic level and overall health score were higher than 24 hours after treatment， with statistical difference （P<0.05）. The recovery time of masticatory efficiency was （19.48±1.12） days. Of the 50 patients， 2 failed and 48 succeeded. The success rate was 96.00%. The patients were followed up until April 2017. No recurrence occurred. Conclusion In the treatment of severe calcaneal bifurcation lesions， dental hemisection combined with fixed bridge repair can significantly improve the periodontal lesions， promote the recovery of masticatory function， improve the quality of life， and the treatment effect is remarkable. It is worth popularizing and applying in clinic.

Key words：tooth hemisection; fixed bridge repair; severe root bifurcation disease; masticatory function; quality of life

根分叉病变是由牙周炎病变所波及的多根牙根分叉区，此病发生后根分叉区会产生牙周袋、牙槽骨被破坏以及附着丧失等症状，目前研究认为，根分叉病变可发生于上下颌磨牙、上颌双尖牙，其中下颌第一磨牙的发病率最高[1-2]。有研究表明，根分叉病变属于一种非独立性的病变，目前临床上对于根分叉病变的诊断较为容易，但治疗较为困难，常规的治疗效果往往不佳，复发率较高，且促使病变不断发展，严重者可导致患者患牙被拔除。本研究旨在探究牙半切除术联合固定桥修复对重度根分叉病变患者咀嚼功能的影响，为临床上重度根分叉病变的治疗提供新方向。

1  资料和方法

1.1 一般资料：随机选取2015年1月-2016年12月笔者医院收治的重度根分叉病变患者50例，其中男26例，女24例，年龄20～55岁，平均年龄（37.5±2.5）岁，均为单颗患牙。……