치은연하소파술과 치은박리수술 후 6개월간의 치료효과에 대한 비교연구

Abstract

[한글]

치은연하소파술과 치은박리수술후 6개월간 치료에 대한 효과를 비교하기 위하여 21명의 치주염으로 진단된 환자에서 초진시 부착상실, 치주낭 깊이, 치태지수를 측정한 뒤 치은연하소파술과 치은박리수술을 시행하였다. 초진시 측정된 부착상실에 따라 Ⅰ군 (부착상실 1-3mm), Ⅱ군(부착상실 4-6mm), Ⅲ군(부착상실 7mm 이상)으로 군을 나누었다. 각 군마다 치석제거술 실시 4주후, 술후 1, 2, 3, 4, 5, 6개월에 부착상실, 치주낭 깊이, 치태지수를 관찰 분석하여 다음과 같은 결론을 얻었다.

1. Ⅰ군(부착상실 1-3mm) 환자의 부착상실은 치석제거술후 증가하였다가 치은연하소파술 1개월후부터는 유의성 있는 감소를 보인 반면(P<0.01) 치은박리수술후 1개월후부터는 감소하다 술후 4개월부터는 증가하였으나 유의성은 없었다

2. Ⅱ군(부착상실 4-6mm) 환자의 부착상실은 치석제거술후 유의성 있는 감소를 보였으며 치은연하소파술과 치은박리수술후 모두 유의성있는 감소를 하였고 두 술식간 비교시 치은연하소파술에서 유의성 있는 더 많은 부착상실의 감소를 보였다(P<0.05).

3. Ⅲ군(부착상실 7mm 이상) 환자의 부착상실은 치석제거술후 유의성 있는 감소를 보였으며 치은연하소파술과 치은박리수술후 모두 유의성있는 감소를 하였고 두 술식간 비교시 치은박리수술에서 유의성 있는 더 많은 부착상실의 감소를 보였다(P<0.05).

4. Ⅰ군(부착상실 1-3mm) 환자의 치주낭 깊이는 치은연하소파술과 치은박리수술후 모두 유의성있는 감소를 하였고 두 술식간 비교시 술후 4개월까지는 치은박리수술에서, 술후 5, 6개월에는 치은연하소파술에서 더 많은 치주낭 깊이의 감소를 보였으나 술후 1,2개월에만 술식간 유의차를 보였다(P<0.05).

5. Ⅱ군(부착상실 4-6mm) 환자의 치주낭 깊이는 치석제거술후 유의성 있는 감소를 보였으며 치은연하소파술과 치은박리수술 모두 유의성 있는 감소를 하였고(P<0.01) 두 술식간 비교시 치은박리수술에서 더 많은 치주낭 깊이의 감소를 보였으나 술후 3개휠에만 술식간 유의차를 보였다.

6. Ⅲ군(부착상실 7mm 이상) 환자의 치주낭 깊이는 치석제거술후 유의성 있는 감소를 보였으며 치은연하소파술과 치은박리수술 모두 유의성 있는 감소를 보였고(P<0.01) 두 술식간 비교시 치은박리수술에서 유의성 있는 더 많은 치주낭 깊이의 감소를 보였다(P<0.05).

7. 치아면에 따른 부착상실의 변화는 Ⅱ군(부착상실 4-6mm) 환자의 경우 협측근원심면에서는 술후 6개월간 술식간 유의성 있는 차이가 없었으며, 치주낭 깊이의 변화는 Ⅲ군(부착상실 7mm이상) 환자의 경우 협면및 협측근원심면에서 술후 3개월까지는 치은박리수술에서 유의성 있는 더 많은 감소를 보였다(P<0.05).

COMPARISON OF THE CLINICAL EFFECT FOLLOWING SUBGINGIVAL CURETTAGE AND FLAP

OPERATI0N OVER 6 MONTHS

Eun Jeong Choi, D.D.S.

Dept. of Dental Science Graduate School, Yonsei University

(Directed by Professor Chong Kwan Kim, D.D.S., M.S.D., Ph.D.)

The purpose of this study was to evaluate the effect over 6months fellowing

subgingival curettage and flap operation.

This study was carried out on 21 individuals with periodontitis. During the phase

of active treatment and for the subsequent 6 months of healing the patients were

subjected to "professional toothcleaning" once every 1 month.

The subjects were separated into three groups on the basis of initial loss of

attachments. These were consisited of group Ⅰ(loss of attachment 1 to 3mm), group

Ⅱ(loss of attachment 4 to 6mm), and group Ⅲ(loss of attachment>7mm).

Probing depths, loss of attachment plaque index were recorded on baseline, 4

weeks after scaling and instructions in oral hygiene measures and 1, 2, 3, 4, 5,

6month after treatments. All data were analyzed statistically.

The results were as follows.

1. For group Ⅰ(loss of attachment 1 to 3mm), there was slight increase in loss

of attachment after scaling but statistically significant reduction after

subgingival curettage over 6 months(P<0.01), and slight increase from 4month to

6month after flap operation, however this increase was not statistically

significant(P>0.01).

2. For group Ⅱ(loss of attachment 4 to 6mm), there was statistical1y significant

reduction in loss of attachment fellowing both treatments. Subgingival curettage

had more reduction than flap operation in loss of attachment(P<0.05).

3. For group Ⅲ(loss of attachment>7mm), there was statistically significant

reduction in loss of attachment following by both treatments. Flap operation had

more reduction than subgingival curettage in loss of attachment(P<0.05).

4. For group Ⅰ(loss of attachment 1 to 3mm), there was statistically significant

reduction in pocket depth following both treatments(P<0.01). There was more pocket

depth reduction in flap operation than subgingival curettage over 4months, but at 5

and 6month, subgingival curettage had more reduction

5. For group Ⅱ(loss of attachment 4 to 6mm), there was statistically significant

reduction in pocket depth following both treatments(P<0.01). Flap operation had

more reduction but not statistically significant difference between both treatments

in pocket depth.

6. For group Ⅲ(loss of attachment>7mm), there was statistically significant

reduction in pocket depth following both treatments(P<0.01). Flap operation had

more reduction than subgingival curettage in pocket depth(P<0.05).

7. For group Ⅱ(loss of attachment 4 to 6mm), buccal - interproximal sites had no

statistically siglificant differences between both treatments over 6 months in loss

of attachment other tooth aspects. For group Ⅲ(loss of attachment>7mm), at buccal

and buccal - interproximal sites, flap operation had statistically significant more

reduction than subgingival curettage in pocket depth compared other tooth aspects

and this difference was sustained until 3 months after treatments(P<0.05)

[영문]

The purpose of this study was to evaluate the effect over 6months fellowing subgingival curettage and flap operation.

This study was carried out on 21 individuals with periodontitis. During the phase of active treatment and for the subsequent 6 months of healing the patients were subjected to "professional toothcleaning" once every 1 month.

The subjects were separated into three groups on the basis of initial loss of attachments. These were consisited of group Ⅰ(loss of attachment 1 to 3mm), group Ⅱ(loss of attachment 4 to 6mm), and group Ⅲ(loss of attachment>7mm).

Probing depths, loss of attachment plaque index were recorded on baseline, 4 weeks after scaling and instructions in oral hygiene measures and 1, 2, 3, 4, 5, 6month after treatments. All data were analyzed statistically.

The results were as follows.

1. For group Ⅰ(loss of attachment 1 to 3mm), there was slight increase in loss of attachment after scaling but statistically significant reduction after subgingival curettage over 6 months(P<0.01), and slight increase from 4month to 6month after flap operation, however this increase was not statistically

significant(P>0.01).

2. For group Ⅱ(loss of attachment 4 to 6mm), there was statistical1y significant reduction in loss of attachment fellowing both treatments. Subgingival curettage had more reduction than flap operation in loss of attachment(P<0.05).

3. For group Ⅲ(loss of attachment>7mm), there was statistically significant reduction in loss of attachment following by both treatments. Flap operation had more reduction than subgingival curettage in loss of attachment(P<0.05).

4. For group Ⅰ(loss of attachment 1 to 3mm), there was statistically significant reduction in pocket depth following both treatments(P<0.01). There was more pocket depth reduction in flap operation than subgingival curettage over 4months, but at 5

and 6month, subgingival curettage had more reduction

5. For group Ⅱ(loss of attachment 4 to 6mm), there was statistically significant reduction in pocket depth following both treatments(P<0.01). Flap operation had more reduction but not statistically significant difference between both treatments

in pocket depth.

6. For group Ⅲ(loss of attachment>7mm), there was statistically significant reduction in pocket depth following both treatments(P<0.01). Flap operation had more reduction than subgingival curettage in pocket depth(P<0.05).

7. For group Ⅱ(loss of attachment 4 to 6mm), buccal - interproximal sites had no statistically siglificant differences between both treatments over 6 months in loss of attachment other tooth aspects. For group Ⅲ(loss of attachment>7mm), at buccal

and buccal - interproximal sites, flap operation had statistically significant more reduction than subgingival curettage in pocket depth compared other tooth aspects

and this difference was sustained until 3 months after treatments(P<0.05)