固定修复后长期敏感保存活髓再修复13例分析  

Analysis of 13 fixed denture cases treated keeping vital pulp due to the long-term postoperative sensitivity

作　　者：刘明丽 郭键[2] 郑立娟 刚金华 陈小冬 

机构地区：[1]大连市口腔医院老年口腔科 [2]中国人民解放军93176部队门诊部

出　　处：《大连医科大学学报》2014年第1期77-80,共4页Journal of Dalian Medical University

摘　　要：目的：探讨临床活髓牙固定修复术后敏感发生的原因与治疗方法。方法2010年1月-2013年1月13例固定修复后3个月以上患者，术后冷水敏感不缓解，或牙龈炎伴敏感就诊，包括43颗活髓牙，经旧修复体拆除，牙周治疗，局麻下重新规范牙体预备，除两颗前牙基牙因经冠延长术后重新调整冠根比需要，进行了根管治疗外，其余41颗均保存活髓，临时冠丁香油氧化锌粘固粉暂粘，两周复诊过敏症状消失，牙龈健康，聚醚橡胶取模完成修复体制作，玻璃离子水门汀粘接。记录再修复术后即刻，3个月，半年牙髓冷水敏感状况，复查牙龈指数（GI），龈沟出血指数（ SBI）。结果13例41颗活髓基牙再修复均无粘接后即刻敏感。3个月，半年复诊牙龈健康，GI：0～1分，SBI：1分，无冷水敏感发生。结论活髓基牙固定修复经规范正确的牙体预备，临时修复体选择合适的暂时粘接材料促进牙髓牙本质复合体创伤愈合，修复体精密的制作，及严格的边缘封闭对消除术后敏感都是不可或缺的方面。一味追求少磨切牙体组织而产生有倒凹的牙体预备并不能减少术后敏感的发生。Objective To find treatment methods of postoperative sensitivity in fixed denture of vital pulp abutment teeth . Methods From 2010 to 2013 there were 13 cases, including 43 vital pulp teeth wearing crowns or bridges , for which post-operative sensitivity lasted more than three months .The old dentures were removed , periodontal treatments were done , then under local anesthesia the abutment teeth were re -prepared .Temporary crowns were made and bonded using zinc oxide eugenol cement .Forty-one teeth of vital pulp were conserved except the root canals of two front teeth , which were treated because of adjusting the crown -root ratio after crown lengthening .Sensitive symptoms disappeared at visit after two weeks , and gingival was healthful .The impression of polyether rubber was done and new restorations were finished and bonded u -sing glass ionomer cement .The indexes were recorded , including pulp immediately cold sensitivity , gingival index （ GI） and sulcus bleeding index （ SBI） at the subsequent visits in three months and six months .Results Thirteen cases of 41 vital pulp teeth did not have the symptom of immediately sensitivity after being bonded .In the first three and six months , the gingival were healthful , and did not have any sensitivity of cold water .Conclusion The strict processes were essential fac-tors to prevent vital pulp abutment from postoperative sensitivity , including tooth preparation correctly , making provisional restorations and selecting suitable temporary bonding material to promote pulp -dentin complex wound healing , making pre-cise closed edge restoration .It didn＇t reduce postoperative sensitivity by undercuting tooth preparation for less grinding tooth tissues.

关 键 词：牙髓牙本质复合体 丁香油氧化锌 固定修复 活髓基牙 

分 类 号：R783.4[医药卫生—口腔医学]