3种边缘设计铸瓷高嵌体修复不同程度缺损无髓磨牙的3年对比研究  

Three-year retrospective clinical evaluation of pulp-less molars with defects of varying degree repaired by cast ceramic onlays of three marginal types

作　　者：强卫林 李雨轩 刘刚 张丽虹 张静洋 曹文瑾 Qiang Weilin;Li Yuxuan;Liu Gang;Zhang Lihong;Zhang Jingyang;Cao Wenjin(Dept.of Prosthodontics,Yinchuan Stomatology Hospital,Ningxia Medical University,Yinehuan 750001,China)

机构地区：[1]宁夏医科大学附属银川市口腔医院口腔修复科,银川750001

出　　处：《华西口腔医学杂志》2018年第5期493-497,共5页West China Journal of Stomatology

摘　　要：目的评价使用3种边缘形式的铸瓷高嵌体修复不同程度缺损无髓磨牙的临床效果。方法选择105例患者的165颗根管治疗后磨牙,根据牙体预备后残留壁的数目分为轻度、中度和重度缺损,每种缺损又根据不同的边缘设计分为平面对接组、斜面组和凹形肩台组,完成牙体预备后行高嵌体修复。治疗后随访,比较同种缺损情况下不同组间的成功率和存活率。结果病例平均随访925.44 d。轻度缺损情况下,平面对接组和斜面组的成功率和存活率均为100%;凹形肩台组的成功率为94.4%,存活率为100%。中度缺损情况下,平面对接组的成功率为96.0%,存活率为100%;斜面组的成功率为80.0%,存活率为93.3%;凹形肩台组的成功率为95.2%,存活率为95.2%。重度缺损情况下,平面对接组的成功率为95.2%,存活率为100%;斜面组的成功率为73.7%,存活率为89.5%;凹形肩台组的成功率为73.3%,存活率为80.0%。各种缺损情况下,3组高嵌体的成功率和存活率均无统计学差异(P>0.05)。结论采用平面对接式边缘的高嵌体牙体预备在轻、中、重度根管治疗后牙体缺损情况下均能取得较满意的临床效果。Objective This study aimed to evaluate the clinical effect of pulp-less molars with defects of different degrees repaired by cast ceramic onlays of three marginal types. Methods A total of 165 endodontically treated molars of 105 patients were included in this study and were divided into three kinds of defect（mild, moderate, severe） according to the number of remaining axial walls. Each defect was divided into three groups according to the shape of edge to edge, bevel edge, and concave shoulder. After tooth preparation, the casting of ceramic onlays was performed. Treatment follow-up was done for the evaluation of the success and survival rates of three groups under the same defect. Results The average follow-up was 925.44 days. Under the mild defect, the success and survival rates of the edge to edge onlays were respectively 100% and 100%; bevel edge onlays, 100% and 100%; and concave shoulder onlays, 94.4% and 100%. Under the moderate defect, the success and survival rates of the edge to edge onlays were respectively 96.0% and 100%; bevel edge onlays, 80.0% and 93.3%; and concave shoulder onlays, 95.2% and 95.2%. Under the severe defect, the success and survival rates of the edge to edge onlays were respectively 95.2% and 100%; bevel edge onlays, 73.7% and 89.5%; and concave shoulder onlays, 73.3% and 80.0%. Under different defects, the success or survival rates of the three kinds of onlays had no significant difference（P〉0.05）. Conclusion The edge to edge type is the most preferable way of onlay tooth preparation and can achieve good clinical results in the mild, middle, and severe tooth defection with root canal treatment.

关 键 词：高嵌体 牙体缺损 铸造陶瓷 根管治疗 磨牙 

分 类 号：R783.3[医药卫生—口腔医学]