南方医科大学学报

南方医科大学学报 ›› 2021, Vol. 41 ›› Issue (11): 1680-1685.doi: 10.12122/j.issn.1673-4254.2021.11.12

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隧道技术在前牙区连续牙龈退缩伴非龋性牙颈部缺损治疗中的临床疗效

谢成婕，廖阳阳，童方丽，方静娴，王 勤，余慧敏   

  1. 南方医科大学口腔医院//广东省口腔医院，广东 广州 510280
  • 出版日期:2021-11-20 发布日期:2021-12-10

Efficacy of tunnel technique for treatment of gingival recession of upper adjacent teeth with noncarious cervical defect

XIE Chengjie, LIAO Yangyang, TONG Fangli, FANG Jingxian, WANG Qin, YU Huimin   

  1. Stomatology Hospital, Southern Medical University, Guangzhou 510280, China
  • Online:2021-11-20 Published:2021-12-10

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摘要： 目的 探讨隧道技术在上前牙区牙龈退缩伴非龋性牙颈部缺损中的临床疗效。方法 收集2019年1月~2021年1月间因上前牙牙龈退缩（GR）伴根面非龋性牙颈部缺损（NCCL）而接受隧道技术的21名患者共79颗患牙的临床资料，根据GR高度（GRD）和NCCL深度（LD）将患牙分成4组：第1组GRD≤3 mm，LD≤1 mm，第2组GRD≤3 mm，LD>1 mm，第3组 GRD>3 mm，LD≤1 mm，第4组GRD>3 mm，LD>1 mm；统计分析各组术后的平均根面覆盖率（MRC），完全根面覆盖率（CRC），角化龈宽度和厚度等临床指标的改善情况。结果 各组术前术后的角化龈宽度及厚度的增加均有统计学差异（P<0.01）；各组间MRC和CRC具有统计学差异（P<0.01）。当GRD≤3 mm时，第1组和第2组MRC分别为98.55%和95.45%（P>0.05）；当GRD>3 mm时，第3组和第4组MRC分别为86%和72%，且CRC较第1组和第2组明显下降，其中第4组与其他3组比较时MRC和CRC均有统计学差异（P<0.01）。结论 隧道技术对改善角化龈的厚度和宽度具有较好的临床疗效，而对于根面覆盖的效果，GRD较NCCL的影响作用更大，提示根面覆盖术前NCCL的充填可能并非必要，需要综合评价GRD和NCCL的共同影响。

关键词: 牙龈退缩；隧道技术；根面覆盖；非龋性牙颈部缺损

Abstract: Objective To evaluate the efficacy of tunnel technique (TUN) in treatment of teeth with adjacent gingival regression (GR) combined with noncarious cervical lesions (NCCL). Methods We collected data from 21 patients (79 teeth) undergoing TUN surgery for GR combined with NCCL. According to GR depth (GRD) and lesion depth (LD) of NCCL, the teeth were divided into group 1 with GRD≤3 mm and LD≤1 mm; group 2 with GRD≤3 mm and LD>1mm; group 3 with GRD>3 mm and LD≤1 mm; and group 4 with GRD>3 mm and LD>1 mm. The mean root coverage (MRC) rate, complete root coverage (CRC) rate, keratinized gingival width, and keratinized gingival thickness were compared among the 4 groups after TUN surgery. Results The keratinized gingival width and thickness were significantly improved after the surgery in the 4 groups. When the GRD was below 3 mm, the MRC was not significantly different between group 1 and group 2 (8.55% vs 95.45%, P>0.05); When the GRD was beyond 3 mm, the MRC and CRC rates were both decreased in group 3 and group 4, especially in group 4, where the CRC rate (25% ) was significantly lower than those in the other 3 groups (P<0.01). Conclusion In patients with GR combined with NCCL, TUN surgery can obviously improve keratinized gingival width and thickness. GRD has a greater effect on the outcome of root coverage than LD, suggesting that NCCL restoration before TUN surgery may not be necessary. Both GRD and LD should be considered in the evaluation of the clinical efficacy of TUN surgery.

Key words: gingival recession; tunnel technique; root coverage; noncarious cervical lesions