Observation Of The Clinical Effect Of All-ceramic Combined Crown Fixed Splint On Loose Anterior Teeth With Severe Periodontitis

Objective To observe the changes of the subjective and objective indexes including inflammation control,functional improvement and patient’s subjective perception,so as to evaluate the clinical effect of all-ceramic combined crown fixed splint on loose anterior teeth with severe periodontitis and provide the basis for its clinical application.Methods Among the patients with severe periodontitis who attended the Department of Periodontal Mucosa of the Affiliated Stomatology Hospital of Anhui Medical University from November 2020 to June 2022,36 patients were finally selected for the study according to the inclusion criteria and patients’ wishes.All patients were given all-ceramic combined crown fixed splint therapy on the basis of complete periodontal initial therapy and stable supportive therapy.A total of 40 all-ceramic combined crown fixed splints were fabricated and divided into the maxillary group(19 all-ceramic combined crown fixed splints)and the mandibular group(21 all-ceramic combined crown fixed splints)according to the location of the loose anterior teeth.Probing depth(PD),bleeding index(BI),plaque index(PLI),tooth mobility(TM),the index of eating difficulty(IED),oral impacts on daily performances(OIDP),satisfaction with the all-ceramic combined crown fixed splint were measured and recorded at different time points of baseline,1 month after initial therapy and 6 months after all-ceramic combined crown fixed splint therapy through oral examination and questionnaire.Then generalized estimating equation was used to evaluate the clinical effect of active periodontal therapy and all-ceramic combined crown fixed splint therapy on loose anterior teeth with severe periodontitis.Results In this study,40 all-ceramic combined crown fixed splints were fabricated,involving a total of 157 loose anterior teeth with severe periodontitis,including the maxillary group(19 all-ceramic combined crown fixed splints,72 loose anterior teeth,average length 5.89 units/case,average abutment 5.05 teeth/case)and the mandibular group(21 all-ceramic combined crown fixed splints,85 loose anterior teeth,average length 5.90 units/case,average abutment 5.24 teeth/case).After active periodontal therapy and all-ceramic combined crown fixed splint therapy,periodontal objective indexes(PD,BI,PLI,TM)had significant improvements in both groups(P<0.05),suggesting that it can effectively control periodontal inflammation;subjective indexes(IED,OIDP)decreased(P<0.05),suggesting that it can improve masticatory function and quality of life.Moreover,the scores of satisfaction with the all-ceramic combined crown fixed splint showed that patients had a high degree of acceptance for this therapy.Conclusion For patients with severe periodontitis,when they have a strong desire to retain loose anterior teeth,all-ceramic combined crown fixed splint therapy can be performed on the basis of complete periodontal initial therapy and stable supportive therapy.Active periodontal therapy and all-ceramic combined crown fixed splint therapy not only allow the patient to obtain and maintain a stable periodontal condition but also improve chewing ability and quality of life.While this treatment can also largely satisfy the patient’s needs for function,aesthetics and comfort.