三种不同核材质和牙本质肩领对前牙残根修复效果影响的临床研究  

Effects of Ferrule Length on the Survival of Pulpless Residual Roots with Three Different Post-and-core Materials

作　　者：王继军 田红梅 孟晓曼 WANG Ji-jun;TIAN Hong-mei;MENG Xiao-man(Department of Stomatology,Langfang TCM Hospital Hebei,Langfang 065000,Hebei,China)

机构地区：[1]廊坊市中医医院口腔科,河北廊坊065000

出　　处：《中国美容医学》2020年第10期134-138,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:比较预成纤维桩核、金属铸造桩核和可塑纤维桩核联合牙本质肩领对前牙残根残冠修复效果的影响。方法:研究对象为2014年3月-2016年3月在笔者医院口腔科进行治疗的102例前牙残冠残根患者,共计120颗患牙,根据桩核材质不同分成三组,预成纤维桩核组(A组)34例,共42颗,金属铸造桩核组(B组)34例,共40颗,可塑纤维组(C组)34例,共38颗。患牙采用不同桩核材料修复后,根据剩余牙体组织量在残根颈部制备一定高度的牙本质肩领,高度分别为0~1mm、1~2mm和>2mm,最后均进行常规烤瓷冠修复。治疗结束后随访3年,统计三组前牙残根修复的成功率,修复1年后咀嚼功能和患牙健康状况,并对结果进行分析。结果:A组、B组和C组的治疗成功率分别为92.85%、82.50%和84.21%,组间差异无统计学意义(P>0.05)。17例修复失败的患牙中,牙本质肩领高度0~1mm有16例、1~2mm有1例,肩领高度超过2mm者全部修复成功,牙本质肩领高度显著影响前牙残根修复的治疗效果(P<0.05)。A组有4颗患牙修复失败,主要以桩核脱落为主,其次是牙龈炎;B组有7颗患牙修复失败,其中2颗桩核脱落,2颗牙根折裂,2颗牙龈边缘着色,还有1颗牙龈发炎;C组有6颗患牙修复失败,其中有4颗桩核脱落,2颗牙龈发炎。三组患牙修复1年后的咀嚼功能差异无统计学意义(P>0.05)。三组患牙修复1年后的健康指数(GI和SBI)均明显低于治疗前,且预成纤维桩核<可塑纤维桩核组<金属桩核组,组间比较差异均具有统计学意义(P<0.05)。结论:三种桩核材料对前牙残冠残根修复成功率和咀嚼功能影响不大,但采用预成纤维桩核进行修复的患牙健康状况明显优于金属铸造桩核和可塑纤维桩核,在残根颈部制备高度1mm以上的牙本质肩领(必要时采用牙冠延长术或联合正畸牵引术),能够明显提高残冠残根修复成功率。Objective To compare the effect of three different post material and ferrule length on the survival of residual crown and roots restored with dowel and crows.Methods 102 patients with 120 defect teeth of residual crown and roots admitted to our hospital from March 2014 to March 2016 were divided into three groups according to different restored material.42 teeth of 34 patients were restored with prefabricated fiber post-and-core group(named Group A),40 teeth of 34 patients were restored with mental cast post-and-core group(named Group B),and 38 teeth of 34 patients were restored with custom-made fiber post-and-core group(named Group C).After dowel restoration,all teeth were prepared with different ferrule lengths and then restored with ceramic crows.The success rate of prostheses three years after restoration,chewing functional efficiency and dental health 1 year after restoration were compared.Results The success rates of prostheses of Group A,Group B and Group C three years after restoration were 92.85%,82.50%and 84.21%,respectively,and there was no significant difference among the three groups(P>0.05).Among 17 teeth failed restoration,16 teeth was with the ferrule length at 0 to 1mm and 1 teeth with the ferrule length at 1 to 2 mm,and no teeth failed to restore with the ferrule length more than 2 mm.Ferrule length significantly affected the survival of residual roots(P<0.05).Among 17 teeth failed restoration,there were 4 teeth in Group A(including 3 teeth post with debonding and 1 teeth with gum inflammation),7 teeth in Group B(including 2 teeth with post debonding,2 teeth with post fracture,2 teeth with gum staining and 1 teeth with gum inflammation),and 6 teeth in Group C(including 4 teeth with post debonding and 2 teeth with gum inflammation).The chewing functional efficiency of the three groups 1 year after restoration had no significant difference(P>0.05).The GI and SBI of teeth in the three groups 1 year after restoration were significantly lower than those before treatment,and the GI and SBI of teeth af

关 键 词：预成纤维桩 金属铸造桩 可塑纤维桩 牙本质肩颈 残根残冠 

分 类 号：R783.4[医药卫生—口腔医学]