터널화가 시행된 대구치의 장기적인 임상적 방사선학적 평가
Long Term Clinical and Radiographical Evaluation of Tunneled Molars
0
조회
0
다운로드
0
인용
0
참고문헌
초록
Purpose: Tunneling is a periodontal surgical procedure that creates access for patient cleansing and maintenance within the furcal area of a molar tooth with severe furcation involvement. Up to date, there are few studies about a long term clinical and radiographic stability of tunneling. The purpose of this retrospective study is to evaluate the long term prognosis after tunnel preparation of molars with through and through furcation. Material and Methods: 25 teeth of 23 patients aged 36 to 70 (mean age 51.7) were treated surgically with tunnel preparation. These cases were followed for 2 to 13 years (mean 6.5years) after surgery. Patients were recalled for an evaluation which was based on a questionnaire, a clinical examination, and radiographic analysis. Clinical assessment included plaque index, caries registration, probing pocket depth, bleeding on probing, tooth mobility. Baseline and over 2-year follow-up radiographs were collected and evaluated for this study. Result: 3 teeth(12%) had been extracted and 1 tooth(4%) hemisected. Root caries was detected in 3 teeth(12%). Thus 72% of the teeth were still caries free and in function. Clinical parameters including PI, PD, BOP, mobility showed somewhat favourable results. Radiographic furcal bone loss showed no statistically significant difference compared to interproximal crestal bone loss (3.59±1.69% vs 3.42±2.95%) when root length was used as reference. There was no correlation between root trunk length and furcal bone loss. Conclusion: Over 2 years after tunneling procedure, teeth showed a clinically and radiographically stable condition, despite of slight root caries and alveolar bone loss within clinically acceptable range. The tunnel procedure may be considered as a viable periodontal treatment option for molar teeth with severe furcation involvement in individuals following a regular maintenance program. (J Korean Acad Periodontol 2008;38:521-528)
Abstract
Purpose: Tunneling is a periodontal surgical procedure that creates access for patient cleansing and maintenance within the furcal area of a molar tooth with severe furcation involvement. Up to date, there are few studies about a long term clinical and radiographic stability of tunneling. The purpose of this retrospective study is to evaluate the long term prognosis after tunnel preparation of molars with through and through furcation. Material and Methods: 25 teeth of 23 patients aged 36 to 70 (mean age 51.7) were treated surgically with tunnel preparation. These cases were followed for 2 to 13 years (mean 6.5years) after surgery. Patients were recalled for an evaluation which was based on a questionnaire, a clinical examination, and radiographic analysis. Clinical assessment included plaque index, caries registration, probing pocket depth, bleeding on probing, tooth mobility. Baseline and over 2-year follow-up radiographs were collected and evaluated for this study. Result: 3 teeth(12%) had been extracted and 1 tooth(4%) hemisected. Root caries was detected in 3 teeth(12%). Thus 72% of the teeth were still caries free and in function. Clinical parameters including PI, PD, BOP, mobility showed somewhat favourable results. Radiographic furcal bone loss showed no statistically significant difference compared to interproximal crestal bone loss (3.59±1.69% vs 3.42±2.95%) when root length was used as reference. There was no correlation between root trunk length and furcal bone loss. Conclusion: Over 2 years after tunneling procedure, teeth showed a clinically and radiographically stable condition, despite of slight root caries and alveolar bone loss within clinically acceptable range. The tunnel procedure may be considered as a viable periodontal treatment option for molar teeth with severe furcation involvement in individuals following a regular maintenance program. (J Korean Acad Periodontol 2008;38:521-528)
참고문헌 (24)
- Wang HL, "The influence of molar furcation involvement and mobility on future clinical periodontal attachment loss", J Periodontol, 65, pp.25~29 (1994)
- Hirschfeld L, "A long-term survey of tooth loss in 600 treated periodontal patients", J Periodontol, 49, pp.225~237 (1978)
- Becker W, "The long term evaluation of periodontal treatment and maintenance in 95 patients", Int J Periodontics Restorative Dent, 4, pp.54~71 (1984)
- McFall WT Jr, "Tooth loss in 100 treated patients with periodontal disease. A long-term study", J Periodontol, 53, pp.539~549 (1982)
- Dannewitz B, "Loss of molars in periodontally treated patients: a retrospective analysis five years or more after active periodontal treatment", J Clin Periodontol, 33, pp.53~61 (2006)
- Müller HP, "Management of furcation-involved teeth. A retrospective analysis", J Clin Periodontol, 22, pp.911~917 (1995)
- Waerhaug J, "The furcation problem. Etiology, pathogenesis, diagnosis, therapy and prognosis", J Clin Periodontol, 7, pp.73~95 (1980)
- Garrett S, "Treatment of mandibular class III periodontal furcation defects. Coronally positioned flaps with and without expanded polytetrafluoroethylene membranes", J Periodontol, 65, pp.592~597 (1994)
- Vandersall DC, "The mandibular molar class III furcation invasion: a review of treatment options and a case report of tunneling", J Am Dent Assoc, 133, pp.55~60 (2002)
- Newell DH, "The diagnosis and treatment of molar furcation invasions", Dent Clin North Am, 42, pp.301~337 (1998)
- Hamp SE, "Periodontal treatment of multirooted teeth. Results after 5 years", J Clin Periodontol, 2, pp.126~135 (1975)
- Hellden LB, "Steffensen JE. The prognosis of tunnel preparations in treatment of class III furcations. A follow-up study", J Periodontol, 60, pp.182~187 (1989)
- Silness J, "Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condtion", Acta Odontol Scand, 22, pp.121~135 (1964)
- Mühlemann HR, "Son S Gingival sulcus bleeding-a leading symptom in initial gingivitis", Helv Odontol Acta, 15, pp.107~113 (1971)
- Miller S.C, "Textbook of periodontia" (1936), Blakiston
- Little LA, "Lack of furcal bone loss following the tunneling procedure", J Clin Periodontol, 22, pp.637~641 (1995)
- Tonetti MS, "Cortellini P. Periodontal regeneration of human infrabony defects. Ⅲ. Diagnostic strategies to detect bone gain", J Periodontol, 64, pp.269~277 (1993)
- Rüdiger SG, "Mandibular and maxillary furcation tunnel preparations-literature review and a case report", J Clin Periodontol, 28, pp.1~8 (2001)
- Eickholz P, "Postsurgical findings after tunnel preparation in mandibular molars with Class III furcation involvement", Dtsch Zahnarztl Z, 46, pp.356~357 (1999)
- Feres M, "Figueiredo LC, Oppermann RV. Clinical evaluation of tunneled molars: a retrospective study", J Int Acad Periodontol, 8, pp.96~103 (2006)
- Ravald N, "Prediction of root surface caries in patients treated for advanced periodontal disease", J Clin Periodontol, 8, pp.400~414 (1981)
- Ravald N, "Long-term evaluation of root surface caries in periodontally treated patients", J Clin Periodontol, 13, pp.758~767 (1986)
- Ash G.M, "Wheeler's Dental Anatomy, Physiology and Occlusion" (1993)
- Bühler H, "Survival rates of hemisected teeth: an attempt to compare them with survival rates of alloplastic implants", Int J Periodontics Restorative Dent, 14, pp.536~543 (1994)