2种瓷贴面粘结方法对龈上皮损伤的比较研究  

Effects of two ceramic veneer bonding methods on gingival health:a clinical study

作　　者：田敏 杨宇 

机构地区：[1]杭州口腔医院特需科,浙江杭州310006

出　　处：《口腔医学》2018年第1期59-61,82,共4页Stomatology

摘　　要：目的比较瓷贴面粘结中用排龈线排龈和直接抛光机械损伤龈上皮对牙龈健康的影响,为临床应用提供参考。方法将牙周健康对称性贴面修复的36颗前牙纳入研究,采用自身左右同源配对的办法,随机分配某侧修复牙为排龈线退龈后粘结,另一侧为直接抛光粘结,健康天然邻牙为对照组。在粘结后1周和2周,对修复体进行回访,使用探诊深度(probing depth,PD)、Mazza出血指数(Mazza index,MI)、菌斑指数(plaque index,PLI)对贴面修复牙和对照牙的牙龈进行检查记录。采用多配对样本的Friedman双向评秩方差检验和两配对样本的非参检验(Wilcomxon)观察2种粘结方法处理后的牙龈和对照组牙龈各项指标的差异(α=0.05)。结果在粘结后1周,排龈组MI1.00(0.75~1.00)和直接抛光组MI1.00(1.00~2.00)与对照牙MI1.00(0.00~1.00)均有显著性差异(P=0.004)。2组间无统计差异(P=0.16)。PLI与PD在两个观测时间点均无显著性差异。术后1年复查,所有病例均未出现明显牙龈退缩及粘结边缘着色。结论瓷贴面粘结中用排龈线排龈和直接抛光均会引起牙龈两周内短期损伤性炎症。2种处理之间并无显著性差异。Objective To compare the effects of two ceramic veneer bonding methods on gingival health, the gingival retraction trau- ma and the mechanical gingival epithelium trauma, and to provide reference for clinical application. Methods Thirty-six symmetrical teeth after veneer preparation of 11 patients who were periodontally healthy were selected in this homologous pairing design. Teeth in one side were randomly chosen to be treated with retraction cord in cementing procedure and the other side with polishing bonding. The healthy adjacent teeth were chosen as the control group. After one week and two weeks after bonding, restoration teeth had a return vis- it. Plaque index （PLI）, probing depth （PD） , and Mazza index （MI）of the restoration teeth were measured after cementation, as well as the adjacent natural teeth. Differences in clinical parameters were analyzed with the Friedman signed ranks test and Wilcoxon signed ranks test （~x = 0.05 ）. One year later, the pigmentation in margin of cementation and visual gingival recession were observed. Results The periodontal parameters were not statistically significant among the groups at two intervals except for the Mazza index（P= 0.004）, which increased in two groups after 1 week while there was no statistical significance（ P= 0.16） between cord group（ 1.00（ 0.75- 1. 00） ）and the cordless group（ 1.00（1.00~2.00） ）. No obvious pigmentation in margin of the cementation and visual gingival recession was observed after one year. Conclusions Both the two techniques injure the gingival health by causing a temporary gingival inflamma- tion which is indicated by Mazza index （MD）and can not be traced after 2 weeks. No statistical significance between the two techniques on gingival health can be measured in a short period.

关 键 词：排龈线 牙龈损伤 瓷贴面 粘结 

分 类 号：R783.3[医药卫生—口腔医学]