玻璃基陶全瓷氧化锆全瓷及纤维桩核氧化锆冠修复对后牙体缺损患者咀嚼能力及龈沟液炎症损伤指标的影响  

Effects of Different Types of Dental Restorations on Masticatory Ability and Gingival Crevicular Fluid Inflammatory Markers in Patients with Posterior Dental Defects

作　　者：杨海珍 张红梅 张帆 刘晓璐 陈新钊 YANG Haizhen;ZHANG Hongmei;ZHANG Fan(The Second Affiliated Hospital of PLA Air Force Military Medical University,Shaanxi Xi'an 710038,China)

机构地区：[1]中国人民解放军空军军医大学第二附属医院口腔科,陕西西安710038

出　　处：《河北医学》2023年第11期1857-1863,共7页Hebei Medicine

基　　金：陕西省重点研发计划项目,(编号:2021KW-61)。

摘　　要：目的:探讨玻璃基陶全瓷、氧化锆全瓷及纤维桩核氧化锆冠修复对后牙体缺损患者咀嚼能力及龈沟液炎症损伤指标的影响。方法:选取根管治疗后择期进行桩核修复治疗的后牙体缺损患者151例(151颗),依照接受冠修复体材质不同分为3组,即选择玻璃基陶全瓷高嵌体修复者为A组,选择氧化锆全瓷冠修复者为B组,选择纤维桩核氧化锆冠修复者为C组,经倾向性评分匹配法对以上病例的基线资料进行分析得出,获取三组均衡可比的基线资料,即A组为51例(51颗),B、C组各为50例(50颗)。评估3组修复后1年后的修复效果,对比3组修复前及修复1年后的咀嚼功能(咬合力、咀嚼效率)、牙周状况[牙龈出血指数(BI)、牙周袋深度(PD)、附着丧失(AL)]及龈沟液炎症损伤指标[白细胞介素-1β(IL-1β)、碱性磷酸酶(ALP)、前列腺素(PGE2)]水平,观察3组并发症情况。结果:A组的修复体完整、颜色匹配、边缘合适性、边缘着色及牙龈状况共5项内容修复合格率均显著高于B、C组(P<0.05);修复1年后,3组咬合力较修复前有显著性增强(P<0.05),咀嚼效率较修复前有显著性提高(P<0.05),其中A组修复前后咬合力和咀嚼效率的差值显著大于B、C组(P<0.05),B组差值显著大于C组(P<0.05);修复1年后,3组龈沟液BI、PD、AL值较修复前有显著性提高(P<0.05),但A组修复前后BI、PD、AL值差值显著小于B、C组(P<0.05),B组差值显著小于C组(P<0.05);修复1年后,3组龈沟液IL-1β、ALP、PGE2较修复前有显著性提高(P<0.05),但A组修复前后龈沟液IL-1β、ALP、PGE2水平差值显著大于B、C组(P<0.05),B组差值显著大于C组(P<0.05);A组修复1年内的总并发症率分别为1.96%,显著低于B、C组的12.00%、18.00%(P<0.05)。结论:相比氧化锆全瓷及纤维桩核氧化锆冠修复,选择玻璃基陶全瓷高嵌体修复用于后牙体缺损根管治疗后,不仅能提高修复效果和咀嚼功能,还能减轻牙周组织和龈沟液�Objective:To explore the effects of glass-based all-ceramic crown,zirconia all-ceramic crown and fiber post core zirconia crown restoration on masticatory ability and gingival crevicular fluid inflammatory injury indicators in patients with posterior dental defects.Methods:A total of 151 patients(151 teeth)with posterior dental defects who underwent selective post-core restoration after root canal therapy were included in this study.They were divided into three groups based on the material used for crown restoration:Group A received glass-based all-ceramic onlay restoration,Group B received zirconia all-ceramic crown restoration,and Group C received fiber post core zirconia crown restoration.Baseline data were analyzed using propensity score matching to obtain balanced and comparable baseline data in each group.The restoration outcomes were evaluated one year after the procedure,and masticatory function(occlusal force,masticatory efficiency),periodontal status(gingival bleeding index,periodontal pocket depth,attachment loss),and gingival crevicular fluid inflammatory markers(interleukin-1β,alkaline phosphatase,prostaglandin E2)were compared before and after restoration.Complications were also assessed.Results:Group A had significantly higher rates of restoration integrity,color matching,edge suitability,edge coloring,and gingival condition compared to Groups B and C(P<0.05).One year after restoration,all three groups showed significant improvements in occlusal force and masticatory efficiency compared to before restoration(P<0.05).Group A exhibited significantly greater improvements in occlusal force and masticatory efficiency compared to Groups B and C(P<0.05),and Group B had significantly greater improvements than Group C(P<0.05).Gingival crevicular fluid inflammatory markers(BI,PD,AL)increased significantly in all three groups after one year of restoration(P<0.05).Group A showed significantly smaller changes in BI,PD,and AL compared to Groups B and C(P<0.05),and Group B had significantly smaller changes than

关 键 词：玻璃基陶全瓷高嵌体 氧化锆全瓷 纤维桩核氧化锆冠 桩核修复 咀嚼能力 龈沟液炎症损伤指标 

分 类 号：R783.3[医药卫生—口腔医学]