前磨牙根管治疗后三种修复方式的抗力研究  

Study on the Resistance of Three Restoration Methods After Root Canal Treatment of Premolars

作　　者：李华珠[1] 肖成琦[1] LI Huazhu;XIAO Chengqi(Department of General,School and Hospital of Stomatology,Fujian Medical University Fujian Stomatological Hospital,Fuzhou Fujian 350002,China)

机构地区：[1]福建医科大学附属口腔医院综合科,福建福州350002

出　　处：《中国卫生标准管理》2022年第15期93-97,共5页China Health Standard Management

基　　金：福建省教育厅中青年教师教育科研项目(JAT190227)。

摘　　要：目的 比较前磨牙根管治疗后CAD/CAM制作嵌体、高嵌体及全冠修复体的抗折性能及折裂模式。方法 选择2020年1月—2022年1月新鲜的离体前磨牙120颗,30颗不做任何处理,作为对照组,另外90颗完善根管治疗后,分成3组:嵌体组(n=30)二硅酸锂嵌体修复,高嵌体组(n=30)二硅酸锂高嵌体修复,全冠组(n=30)氧化锆全冠修复。所有样本牙经过冷热循环和抗疲劳处理后,用电子万能试验机进行抗折裂载荷试验,测试各组样本牙的抗折能力,观察其折裂模式。试验结果采用方差分析进行统计学处理。结果 各组抗折载荷分别为:对照组(977.00±95.38)、嵌体组(974.30±62.36)、高嵌体组(1 695.71±120.69)、全冠组(2232.70±138.33)。对照组和嵌体组间抗折裂性能差异无统计学意义(P> 0.05),可见嵌体修复虽能恢复牙体外形,但未能明显提高牙体的抗折裂性能。高嵌体组和全冠组两组抗折裂性能明显优于对照组,差异有统计学意义(P <0.05),可见高嵌体、全冠都能增加根管治疗后前磨牙的抗折裂能力,保护剩余牙体。折裂模式组间对比:可修复性折裂(折裂模式Ⅰ、Ⅱ、Ⅲ)与不可修复性折裂(折裂模式Ⅳ)对比差异无统计学意义(P> 0.05),未观察到折裂模式有明显优势的修复方式。结论 嵌体修复虽能恢复牙体外形,但未能明显提高RCT后牙齿的抗折性能,临床推荐时必须谨慎。高嵌体修复在提高牙体抗折裂性能的同时又能保留较多的牙体组织,实现微创修复,值得临床推广。Objective To compare the fracture resistance and fracture modes of inondo, high inondo and full crown restorations made by CAD/CAM after root canal treatment of premolars. Methods A total of 120 fresh isolated premolals from January 2020 to January 2022, 30 of which were treated without any treatment, were selected as the control group, and 90 of which were treated with complete root canal treatment were divided into 3 groups: inset group(n=30) with lithium disilicate inset restoration, high inset group(n =30) with lithium disilicate inset restoration and full crown group(n=30) with zirconia. All samples were subjected to thermal and cold cycling and anti-fatigue treatment, then anti-cracking load experiment was carried out with electronic universal testing machine to test the anti-cracking capacity of each sample and observe its cracking mode. The results were statistically analyzed by anova. Results The flexural load of each group was as follows:control group(977.00±95.38), inlay group(974.30±62.36), high inlay group(1 695.71±120.69), full crown group(2 232.70±138.33). There was no significant difference in the fracture resistance between the control group and the inlay group(P > 0.05), indicating that the inlay restoration could restore the tooth shape, but could not significantly improve the fracture resistance of the tooth. The anti-fracture performance of the high inondo group and the full crown group was significantly better than that of the control group, the difference was statistically significant(P < 0.05), indicating that both the high inondo group and the full crown group could increase the anti-fracture ability of the premolars after root canal treatment and protect the remaining teeth. Comparison between fracture mode groups: repairable fracture(fracture mode Ⅰ, Ⅱ, Ⅲ) and non-repairable fracture(fracture mode Ⅳ) were compared, and there was no statistically significant difference between the two fracture modes(P > 0.05), and no obvious superior repair mode was observed with fracture mod

关 键 词：根管治疗 嵌体 高嵌体 全冠修复体 抗折能力 折裂模式 

分 类 号：R783[医药卫生—口腔医学]