全瓷冠修复下颌第二磨牙远中缺损龈壁提升后的美学效果及生物力学性能研究  

Study on the aesthetic effect and biomechanical properties of all-ceramic crown for repairing distal defect of mandibular second molar following deep maxgin elevation

作　　者：程楠 柴丛娜[2] 刘英奇[2] 程磊 Cheng Nan;Chai Congna;Liu Yingqi;Cheng Lei(Handan Hospital of Traditional Chinese Medicine Oral Comprehensive Department,Handan 056002;Department of Stomatology,Handan Central Hospital,Handan 056001)

机构地区：[1]邯郸市中医院口腔综合科,邯郸056002 [2]邯郸市中心医院口腔综合科,邯郸056001

出　　处：《口腔材料器械杂志》2024年第4期214-220,236,共8页Chinese Journal of Dental Materials and Devices

基　　金：河北省医学科学研究课题计划项目(20210410)。

摘　　要：目的探讨下颌第二磨牙远中缺损龈壁提升后给予全瓷冠修复的美学效果及生物力学性能。方法选择2021年2月至2023年2月我院收治的因第二磨牙远中缺损行龈壁提升后给予全瓷冠修复的40例患者作为观察组,另选40例行龈壁提升后给予金属桩钴铬烤瓷冠修复的第二磨牙远中缺损患者作为对照组。比较两组患者修复后12个月的修复效果和各结构的生物力学性能分布;比较两组修复前及修复后12个月的牙周状况和美学效果评分;采用广义估计方程评价全瓷冠修复对患牙美学效果和生物力学性能的影响;比较两组患者的修复满意度。结果观察组在边缘密合性、颜色匹配、牙龈健康方面的修复成功率明显高于对照组(P<0.05);两组患者修复前的牙龈指数(GI)、牙周探诊深度(PD)、龈沟液(GCF)量、美学效果的主观评分和客观评分差异无统计学意义(P>0.05),两组患者修复后12个月的GI、PD、GCF、主观评分和客观评分较修复前均明显增加,观察组的GI、PD、GCF明显小于对照组,主观评分和客观评分明显高于对照组(P<0.05);观察组修复体、粘接剂、牙本质、牙釉质的垂直向载荷应力、斜向载荷应力较对照组均明显减小(P<0.05);广义估计方程评价结果显示,全瓷冠修复能够减轻对患牙牙周健康状况的影响,生物力学性能较好;观察组修复12个月后修复满意度评价为A级的患者比例明显高于对照组(P<0.05)。结论下颌第二磨牙远中缺损龈壁提升后给予全瓷冠修复能够提高美学效果评分,维持良好的生物力学性能,减轻对患牙牙周健康的影响。Objective To investigate the aesthetic effect and biomechanical properties of all-ceramic crown after raising sub-gingival margins of the distal defect of the mandibular second molar.Methods 40 cases of patients with distal defects of second molars treated in the hospital from February 2021 to February 2023 were selected as the observation group after deep margin elevation(DME)and restoration with all-ceramic crowns.Another 40 cases of patients with distal defects of the second molars repaired by metal post cobalt-chromium ceramic crowns after sub-gingival margins rasing were selected as the control group.Compare the restorative effect and the biomechanical property distribution of various structures of the two groups after 12 months of restoration.Compare the periodontal conditions and aesthetic effect scores of the two groups before and after 12 months of restoration.The generalized estimating equation was used to evaluate the effect of all-ceramic crown restoration on the aesthetics and biomechanical properties of the involved teeth.The satisfaction with the restoration was compared between the two groups of patients.Results The success rate of marginal stability,color matching and gingival health in the observation group was significantly higher than that in the control group(P<0.05).There was no sig‐nificant difference in gingival index(GI),periodontal probing depth(PD),gingival crevicular fluid(GCF),subjec‐tive and objective scores of aesthetic effect between the two groups(P>0.05).The GI,PD,GCF,subjective and objective scores of the two groups after restoration for 12 months were higher than those before restoration,but the GI,PD and GCF of the observation group were significantly lower than those of the control group,and the subjec‐tive and objective scores in the control group were significantly higher than those in the control group(P<0.05).The vertical and oblique load stress of restoration,adhesive,dentin and enamel in the observation group were sig‐nificantly lower than those in the control g

关 键 词：下颌第二磨牙远中缺损 全瓷冠修复 龈壁提升 美学效果 生物力学性能 

分 类 号：R783.3[医药卫生—口腔医学]