【摘要】 目的：探讨不同牙周手术治疗末端磨牙远中面深牙周袋的疗效，归纳总结影响其术式选择的因素。方法：回顾性分析2019年3月—2021年12月在武汉大学口腔医院牙周科就诊的37例（39颗患牙）慢性牙周炎患者的临床资料。患者有至少1颗末端磨牙远中面存在基础治疗后无法消除的牙周袋。根据术式选择将患者分为牙龈切除术组（11例，13颗患牙）、楔形瓣及牙周骨成形术组（13例，13颗患牙）和楔形瓣及牙周再生术组（13例，13颗患牙）。观察术前、术后4周及术后12周3组患者的探诊深度及临床附着丧失的改变。结果：牙龈切除术、楔形瓣及牙周骨成形术、楔形瓣及牙周再生术都有效降低了探诊深度及临床附着丧失（P值均<0.05）。结论：牙周手术治疗可以有效处理末端磨牙远中面深牙周袋。牙弓位置、操作空间、牙周软硬组织形态及角化龈的量是选择术式的重要参考指标。更多还原

【Abstract】 Objective: To investigate the curative effect of different periodontal surgeries in the treatment of deep periodontal pockets on the distal surface of terminal molars, and to summarize the factors that affect the choice of surgical procedure. Methods: The clinical data of 37 patients(39 teeth) with chronic periodontitis who were treated in the Department of Periodontology, School of Stomatology, Wuhan University from March 2019 to December 2021 were retrospectively analyzed. The patient had a periodontal pocket in the distal surface of at least one terminal molar that could not be eliminated after basic treatment. The patients were divided into gingivectomy group(11 cases, 13 teeth), distal wedge procedure combined with osteoplasty group(13 cases, 13 teeth) and distal wedge procedure combined with regeneration surgery group(13 cases, 13 teeth) according to the choice of surgical procedure. The changes of probing depth and clinical attachment loss in the three groups were observed before surgery, 4 weeks after surgery and 12 weeks after surgery. Results: Gingivectomy, distal wedge procedure combined with osteoplasty, distal wedge procedure combined with regeneration surgery all effectively reduced probing depth and clinical attachment loss(all P<0.05). Conclusion: Periodontal surgery can effectively treat deep periodontal pockets in the distal surface of terminal molars. The position of the dental arch, the operating space, the morphology of the periodontal soft and hard tissues, and the zone of attached gingiva present are important reference indicators for the selection of surgical procedure.更多还原