口内粘接联合冠修复治疗纵折后牙的疗效研究  

Therapeutic effect of intraoral adhesion combined with crown restoration on vertical fractures of posterior teeth

作　　者：张玲 冯浩 张馨月 郭玲 ZHANG Ling;FENG Hao;ZHANG Xinyue;GUO Ling(Department of Prosthodontics,the Affiliated Oral Hospital,Southwest Medical University,Luzhou 646000,Sichuan Province,China;Department of Oral&Maxillofacial Surgery,the Affiliated Oral Hospital,Southwest Medical University,Luzhou 646000,Sichuan Province,China;Department of Endodontics,the Affiliated Oral Hospital,Southwest Medical University,Luzhou 646000,Sichuan Province,China)

机构地区：[1]西南医科大学附属口腔医院修复科,四川泸州646000 [2]西南医科大学附属口腔医院口腔颌面外科,四川泸州646000 [3]西南医科大学附属口腔医院牙体牙髓科,四川泸州646000

出　　处：《西南医科大学学报》2019年第6期546-549,共4页Journal of Southwest Medical University

基　　金：西南医科大学附属口腔医院课题(2016010)

摘　　要：目的:本研究旨在通过口内粘接加金属全冠修复保存根管治疗(root canal therapy,RCT)后无症状的纵折恒后牙,以评估纵折恒后牙常规保存法的的临床意义及其疗效。方法:选取西南医科大学附属口腔医院2017年1~12月所有完善RCT无症状的恒后牙纵折患者,根据纳入标准筛选,在相对无菌条件下,修整处理断面牙体组织,super Bond(C&B)树脂粘结剂(Sun Medical,Tokyo,Japan)粘接牙冠断面,牙体预备,行患牙金属全冠修复,并分别于3、6、12、18、24月定期随访,根据牙体、牙周、根尖x片等评估粘接加全冠修复治疗保存纵折恒后牙的临床疗效。结果:纳入患者52名,共68颗患牙,位于第一第二磨牙,年龄分布于17~48岁,24月后能正常行使咀嚼功能的患牙为53颗,其中28颗偶尔存在轻度的咬诊或叩诊不适或牙周膜间隙增宽。因牙体或牙周问题拔除患牙13颗,2例失访,3、6、12、18、24月存活率分别为98.53%、95.59%、88.06%、83.58%、80.30%。结论:粘接加冠修复治疗短期内可保存部分根管治疗后无症状的纵折恒后牙,但需要严格控制纵折患牙的适应症且有待长期随访观察进一步的疗效。Objective: To investigate the clinical significance and therapeutic effect of routine preservation, in-traoral adhesion combined with full metal crown restoration, in asymptomatic vertical fractures of permanent posteri-or teeth after root canal therapy(RCT). Methods: We enrolled patients with asymptomatic vertical fractures of per-manent posterior teeth who had received RCT in Hospital of Stomatology, Southwest Medical University, from Janu-ary to December, 2017, according to the inclusion criteria. Under relatively aseptic conditions, the fracture surfacesof the teeth were trimmed and then bonded together with the resin adhesive super bond C&B(Sun Medical, Tokyo,Japan), followed by tooth preparation and full metal crown restoration. The patients were followed up at 3, 6, 12, 18,and 24 months, and X-ray of the teeth, periodontal tissue, and root apexes was performed to assess the efficacy of thecombination treatment for preserving the permanent posterior teeth with vertical fractures. Results: A total of 52 pa-tients(68 fractured teeth involving the first and second molars) were included. The patients were aged from 17 to 48 years. After 24 months, 53 teeth had normal function of mastication, 28 of which had occasional mild biting or per-cussion discomfort or widened periodontal ligament space. Thirteen teeth were extracted because of dental or peri-odontal problems. Two patients were lost to follow-up. The survival rates of the teeth at 3, 6, 12, 18, and 24 monthswere 98.53%, 95.59%, 88.06%, 83.58%, and 80.30%, respectively. Conclusion: Intraoral adhesion combined withcrown restoration can preserve most of permanent posterior teeth with asymptomatic vertical fractures after RCT inshort term, but indications should be strictly reviewed, and the therapeutic effect needs to be further examined bylong-term follow-up.

关 键 词：粘接 冠修复 纵折 

分 类 号：R78[医药卫生—口腔医学]