冠修复及冠修复体对牙周组织和牙周生物标志物变化的影响  

Effect of crown restoration and crown prosthesis on periodontal tissue and periodontal biomarkers

作　　者：张婧 张钊[1] Zhang Jing;Zhang Zhao(Department of Prosthodontics,Hebei Key Laboratory of Stomatology,Hebei Clinical Research Center for Oral Diseases,School and Hospital of Stomatology,Hebei Medical University,Shijiazhuang 050017,Hebei Province,China)

机构地区：[1]河北医科大学口腔医学院·口腔医院修复科,河北省口腔医学重点实验室,河北省口腔疾病临床医学研究中心,河北省石家庄市050017

出　　处：《中国组织工程研究》2022年第34期5543-5552,共10页Chinese Journal of Tissue Engineering Research

基　　金：河北省财政厅2020年政府资助临床医学优秀人才培养项目带头人(2020048149-2),项目负责人:张钊;河北省卫生健康委员会医学科学研究课题计划指令性课题(20190098),项目负责人:张钊。

摘　　要：背景:冠修复体作为一种常见的修复牙体缺损的口腔材料,对口腔内牙周尤其是龈沟液内微生态环境产生影响,可表现为龈沟液内某种生物标志物的变化。目的:通过分析冠修复影响牙周生物标志物的原因及应用研究进展,评价冠修复的效果,从微观上揭示冠修复体对牙周组织的影响,以期指导临床中冠修复体的选择。方法:检索中国知网、万方数据、中文科技期刊数据库及PubMed数据库收录的相关文献。英文检索词为"Crown restoration,Gingival crevicular fluid,Periodontal,Inflammation,Biomarker",中文检索词为"冠修复、龈沟液、牙周、炎症、生物标志物",最终纳入63篇文献进行归纳总结。结果与结论:(1)冠修复体可通过冠材料、冠边缘的密合度及预备形式、冠边缘位置、轴面形态因素影响牙周组织的修复。(2)冠修复对牙周组织影响的生物标志物主要包括细菌、炎症递质、酶类和骨吸收生物标志物共4类。(3)冠修复后龈沟液内变形链球菌、牙龈卟啉单胞菌、伴放线聚集杆菌、白细胞介素1、白细胞介素6、肿瘤坏死因子α、天冬氨酸转移酶、碱性磷酸酶、基质金属蛋白酶8、核因子κB受体活化因子配体/骨保护素等标志物水平的升高可提示牙周组织的炎症状态,针对这些标志物进行动态监测,有助于评价冠修复体对牙周组织的适应性,从而帮助医师在临床上合理地选择冠修复体类型。BACKGROUND:As a common dental material for repairing tooth defects,crown prosthesis has an influence on the oral periodontium,especially the microecological environment in gingival crevicular fluid,which may be represented by the change of some biomarkers in gingival crevicular fluid.OBJECTIVE:By analyzing causes and research progress on application of periodontal biomarkers affected by crown restoration,the effect was evaluated,and the influence of crown restoration on periodontal tissue was revealed microcosmically,in order to guide the selection of crown restoration in clinical practice.METHODS:We searched relevant articles included in CNKI,Wanfang Data,Chinese Science and Technology Journal Database,and PubMed database with the keywords of"Crown restoration;Gingival crevicular fluid;Periodontal;Inflammation;Biomarker"in Chinese and English,and 63 articles were included for summary.RESULTS AND CONCLUSION:(1)The periodontal tissue can be affected by different materials,crown edge tightness and preparation form,crown edge position,axial plane morphology and other aspects.(2)The biomarkers involved in periodontium affected by crown restoration include bacteria,inflammatory mediators,enzymes,and bone resorption biomarkers.(3)After crown restoration,the increased levels of Streptococcus mutans,Porphyromonas gingivalis,Actinobacillus actinomycetemcomitans,interleukin 1,interleukin 6,tumor necrosis factorα,aspartate transferase,alkaline phosphatase,matrix metalloproteinase 8,and nuclear factor kappa B receptor activator ligand/osteoprotegerin in the gingival crevicular fluid can indicate the inflammatory state of periodontal tissue.The dynamic monitoring of these biomarkers is helpful to evaluate the adaptability of crown restoration to periodontal tissue,so as to provide clinical convenience for the reasonable application of crown restoration.

关 键 词：冠修复 龈沟液 生物标志物 炎症 细菌 炎症递质 酶 骨吸收 

分 类 号：R452[医药卫生—治疗学] R318[医药卫生—临床医学]