玻璃陶瓷全瓷冠桥联合多根管玻璃纤维桩对前牙大面积缺损的修复效果及美学效果  

The Restoration Effect and Aesthetic Effect of Glass Ceramic All Ceramic Crown Bridge Combined with Multiple Tube Glass Fiber Posts on Large-area Anterior Tooth Defects

作　　者：朱政 高姗[2] 庞敏[3] 张晓卫[4] 符苏杰[4] ZHU Zheng;GAO Shan;PANG Min;ZHANG Xiao-wei;FU Su-jie(Department of Special Dental Clinic,The Affiliated Stomatological Hospital of Nanjing Medical University,Nanjing,Jiangsu,210029,China;Department of Oral Implantology,The Affiliated Stomatological Hospital of Nanjing Medical University,Nanjing,Jiangsu,210029,China;Fourth Outpatient Department,The Affiliated Stomatological Hospital of Nanjing Medical University,Nanjing,Jiangsu,210029,China;Department of Stomatology,The Second Hospital of Traditional Chinese Medicine of Jiangsu Province/The Second Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu,210017,China)

机构地区：[1]南京医科大学附属口腔医院口腔特诊科,江苏南京210029 [2]南京医科大学附属口腔医院口腔种植科,江苏南京210029 [3]南京医科大学附属口腔医院第四门诊部,江苏南京210029 [4]江苏省第二中医院/南京中医药大学第二附属医院口腔科,江苏南京210017

出　　处：《现代生物医学进展》2025年第3期557-565,共9页Progress in Modern Biomedicine

基　　金：江苏省医学创新中心项目(CXZX202227)。

摘　　要：目的:探讨玻璃陶瓷全瓷冠桥联合多根管玻璃纤维桩对前牙大面积缺损的修复效果及美学效果。方法:选取我院2021.1-2024.1收治的90例前牙大面积缺损患者进行回顾性分析,依照患者选择的治疗方式分为玻璃陶瓷组和金属组,各45例。金属组采取烤瓷熔附金属(钴铬合金)全冠桥联合铸造金属桩核治疗,玻璃陶瓷组采取玻璃陶瓷全瓷冠桥联合多根管玻璃纤维桩治疗。对所有患者进行6个月门诊复查随访,比较其近远期疗效,修复前后龈沟液相关标志物,牙周状况,咀嚼功能与美学评分及并发症发生率。结果:通过对比近远期疗效发现,玻璃陶瓷组总有效率95.56%,金属组总有效率93.33%,两组比较无明显差异(P>0.05),玻璃陶瓷组修复成功率91.11%,金属组修复成功率75.56%,璃陶瓷组高于金属组(P<0.05);通过对比修复前后龈沟液相关标志物发现,修复前玻璃陶瓷组、金属组ALP、ICAM1、MMP-2比较无明显差异(P>0.05),修复后两组患者ALP、ICAM1、MMP-2水平均升高,但玻璃陶瓷组低于金属组(P<0.05);通过对比修复前后牙周状况发现,修复前玻璃陶瓷组、金属组CAL、PD及SBI水平比较无明显差异(P>0.05),修复后两组患者CAL、SBI、PD水平均升高,但玻璃陶瓷组低于金属组(P<0.05);通过对比咀嚼功能与美学评分发现,修复前玻璃陶瓷组、金属组美学评分、咀嚼功能评分比较无明显差异(P>0.05),修复后两组患者美学评分、咀嚼功能评分均升高,玻璃陶瓷组高于金属组(P<0.05);通过对比6个月内并发症发现,玻璃陶瓷组并发症发生率低于金属组(P<0.05)。结论:前牙大面积缺损采取玻璃陶瓷全瓷冠桥联合多根管玻璃纤维桩修复远期效果更优,且可减轻对患者龈沟液和牙周组织影响,提升咀嚼功能,改善牙周美学效果,安全性高。Objective:To investigate the restoration and aesthetic effects of glass ceramic all ceramic crowns and bridges combined with multiple tube glass fiber posts on large-area anterior tooth defects.Methods:A retrospective analysis was conducted on 90 patients with extensive anterior tooth defects admitted to our hospital in the 2021.1-2024.1.According to the treatment method chosen by the patients,they were divided into a glass ceramic group and a metal group,with 45 cases in each group.The metal group was treated with porcelain fused to metal(cobalt chromium alloy)full crown and bridge combined with cast metal post and core,while the glass ceramic group was treated with glass ceramic full ceramic crown and bridge combined with multiple tube glass fiber posts.Conduct a 6-month outpatient follow-up for all patients to compare their short-term and long-term efficacy,gingival crevicular fluid related markers before and after restoration,periodontal condition,chewing function and aesthetic scores,and incidence of complications.Results:By comparing the short-term and long-term efficacy,it was found that the total effective rate of the glass ceramic group was 95.56%,and the total effective rate of the metal group was 93.33%.There was no significant difference between the two groups(P>0.05).The repair success rate of the glass ceramic group was 91.11%,and the repair success rate of the metal group was 75.56%,with the glass ceramic group being higher than the metal group(P<0.05);By comparing the gingival crevicular fluid related markers before and after repair,it was found that there was no significant difference in alkaline phosphatase(ALP),intercellular adhesion molecule 1(ICAM1),and matrix metalloproteinase 2(MMP-2)levels between the glass ceramic group and the metal group before repair(P>0.05).After repair,the levels of ALP,ICAM1,and MMP-2 increased in both groups,but the glass ceramic group was lower than the metal group(P<0.05);By comparing the periodontal conditions before and after restoration,it was found that there

关 键 词：玻璃陶瓷 全瓷冠桥 多根管玻璃纤维桩 前牙大面积缺损 修复效果 美学效果 咀嚼功能 

分 类 号：R3[医药卫生—基础医学] R783.3