冠修复材料导热性对基牙牙髓健康影响的研究  

Study on the effect of the thermal conductivity of crown repair materials on the health of the tooth pulp

作　　者：丁永 王飞 丁国伟 孙旭东 DING Yong;WANG Fei;DING Guowei;SUN Xudong(Department of Prosthodontics,Dental Institute of Hongkou,Shanghai 200083,China)

机构地区：[1]上海市虹口区牙病防治所口腔修复科,上海200083

出　　处：《口腔医学》2019年第1期48-51,共4页Stomatology

基　　金：上海市虹口区卫生和计划生育委员会科研课题计划资助(虹卫1802-243)

摘　　要：目的研究金合金、金合金烤瓷、氧化锆全瓷等修复材料的导热性对牙髓健康的影响。方法 (1)实验室测量金合金、金合金烤瓷、氧化锆全瓷、自体牙、树脂粘接剂的导热系数;(2)随访金合金烤瓷冠、金合金铸造冠(颊侧烤瓷)和氧化锆全瓷冠修复的158颗活髓牙2年;对比158颗自体邻牙,统计出现牙髓炎、根尖周炎的牙数,并与几种材料的导热系数对照。结果树脂粘接后,86%金合金导热系数37.89 W/(m·K),21颗活髓基牙出现3例牙髓炎; 86%金合金烤瓷导热系数0.85 W/(m·K),58颗活髓基牙出现1例牙髓炎;氧化锆全瓷导热系数0.82 W/(m·K),79颗活髓基牙无牙髓炎、根尖周炎发生;天然牙导热系数0.66 W/(m·K),158颗活髓基牙无牙髓炎、根尖周炎发生; 86%金合金铸造冠修复的基牙牙髓炎、根尖周炎阳性率远远高于其他几种低导热系数冠修复材料基牙(P<0.01)。结论冠修复材料的自身导热性能够影响基牙牙髓健康,如过高会对基牙牙髓健康不利。建议把导热系数最接近天然牙的氧化锆全瓷+树脂粘接剂组合作为冠修复材料的首选。Objective To study the effects of the thermal conductivity of gold-alloy,gold-alloy-porcelain,zirconia all-ceramic on the health of the tooth pulp. Methods The coefficients of thermal conductivity of gold-alloy,gold-alloy-porcelain,zirconia all-ceramic,autogenous teeth,composite resin cement were measured in the laboratory. 158 vital pulp abutment teeth repaired by gold alloy casted full crowns,gold-alloy-porcelain crowns and zirconia all-ceramic crowns were followed up for 2 years. Compared with 158 autogenous adjacent teeth,the numbers of cases of pulpitis and apicitis were counted,and then compared with the coefficients of thermal conductivity of the materials. Results After resin bonding,the thermal conductivity coefficient of 86% gold-alloy was 37.89 W/(m·K),3cases of pulpitis occurred in 21 vital pulp abutment teeth. The thermal conductivity coefficient of 86% gold-alloy-porcelain was 0. 85W/(m·K),1 case of pulpitis occurred in 58 vital pulp abutment teeth. The thermal conductivity coefficient of zirconia all-ceramic was 0.82 W/(m·K),no case of pulpitis and apicitis occurred in 79 vital pulp abutment teeth. The thermal conductivity coefficient of healthy teeth was 0.66 W/(m·K),no case of pulpitis and apicitis occurred in 158 vital pulp abutment teeth. The positive rates of pulpitis and apicitis of abutment teeth restored by 86% gold-alloy-porcelain crowns were significantly higher than those of abutment teeth restored by other crow restoration materials with low thermal conductivity coefficient(P < 0. 01). Conclusions Abutment teeth pulp health can be influenced by the thermal conductivity of crowns,for example,too high crown thermal conductivity has a negative effect on the health of the tooth pulp. It is recommended that the combination of zirconia ceramic + resin adhesive with the closest thermal conductivity to natural teeth be the first choice for crown restoration materials.

关 键 词：金合金烤瓷 氧化锆全瓷 导热系数 牙髓牙本质复合体 牙髓炎 

分 类 号：R783.1[医药卫生—口腔医学]