金属烤瓷修复体的临床疗效观察
摘要
目的:探讨金属烤瓷修复体的修复效果,总结成功及失败的经验教训,提高口腔修复水平,为临床应用提供参考。方法:84例门诊患者,经金属烤瓷冠修复治疗0.5～7年,共计488个金属烤瓷冠,通过为期6个月的回访复查,采用美国加利福尼亚科学会的质量评价体系对金属烤瓷固定修复体进行临床效果评价。结果:84例患者488个金属烤瓷冠修复体中固位满意率为97.3%,边缘完整性满意率为94.6%,牙周健康满意率为95.2%,表面和颜色满意率为97.9%;活髓基牙牙髓病变率为10.25%;金属烤瓷修复体按不同时间段观察修复效果,发现各项指标的满意率在不同时间段比较无统计学差异;活髓基牙与无髓基牙的临床修复效果比较也未见统计学差异。结论:金属烤瓷冠修复仍是目前理想的固定修复方法,但在病例选择、修复体设计与制作、基牙的处理以及修复体的选色与配色方面,必须遵循相应的原则与方法,才能保证其满意的临床效果。
Objective: To observe the clinical therapy effects of the porcelain-fused-to-metal (PFM) prosthesis and to summarize the experience and lessons from success and failure. Methods: 488 restorations made by metal porcelain complete crown or fixed-bridge selected from 84 cases which have received this therapy after 0.5 to 7 years were followed up for 6 months. The clinical effects of these subjects were assessed by the California Dental Association(CDA) quality assessment evaluation system. Results: It showed that the satisfactory rates of the retention , marginal integrity, periodontal health, surface and color of the crowns were97.3%,94.6%,95.2%, 97.9% respectively, and the rate of the vital abutment teeth with pulpitis was 10.25%. we had observed above had no significant differences in the different times after the restoration. The indications between the vital and pulpless abutment teeth had no significant differences also. Conclusion: PFM prosthesis is still the ideal method in the fixed prostheses. But the restoration principles must be followed during the case selection, prosthesis design and making, abutment preparation, shade match in order to have a satisfactory clinical result.
Objective: To observe the clinical therapy effects of the porcelain-fused-to-metal (PFM) prosthesis and to summarize the experience and lessons from success and failure. Methods: 488 restorations made by metal porcelain complete crown or fixed-bridge selected from 84 cases which have received this therapy after 0.5 to 7 years were followed up for 6 months. The clinical effects of these subjects were assessed by the California Dental Association(CDA) quality assessment evaluation system. Results: It showed that the satisfactory rates of the retention , marginal integrity, periodontal health, surface and color of the crowns were97.3%,94.6%,95.2%, 97.9% respectively, and the rate of the vital abutment teeth with pulpitis was 10.25%. we had observed above had no significant differences in the different times after the restoration. The indications between the vital and pulpless abutment teeth had no significant differences also. Conclusion: PFM prosthesis is still the ideal method in the fixed prostheses. But the restoration principles must be followed during the case selection, prosthesis design and making, abutment preparation, shade match in order to have a satisfactory clinical result.
引文
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[14]Bemd Reitemeier,Eeffect of posterior crown margin placement on gingival health[J].J Prosthet Dent,2002,87:167-172.
[15]吕卉,杨晓东,陈明.镍铬合金烤瓷修复体局部牙龈组织的电镜和X线能谱分析[J].中国医科大学学报,2001,30(5):385-387.
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[17]陈吉华.烤瓷冠修复引起的牙周组织损害.实用口腔医学杂志,2002,18(3):280-282
[18]陈吉华.与牙冠修复相关的牙周组织结构.实用口腔医学杂志,2002,18(4):373-376
[19]袁玉珠,孙默予,金属烤瓷修复体远期疗效评价,现代口腔医学杂志,1999,13 (2):109-110
[20]叶剑涛,常少海,潘朝斌,等,高金合金烤瓷修复体的临床应用,新医学,2003,34(2):88-90
[21]朱松,韩英杰.烤瓷烧结次数对镍铬合金表面氧化膜形成的影响[J].现代口腔医学杂志,2000,14(4):227-278.
[22]徐军,郭娟丽.烤瓷用镍.铬合金金属氧化膜研究[J].中华口腔医学杂志,1999,34(5):310-311.
[23]Ito H,Okade T,Ishida T,et al.Treatment and analysis of clinical case of gingival pigmentation around the restored teeth[J].Dtsch Zah2 narztz I,1990,34(1):1-6.
[24]Geller W,Kwiatkowski SJ.The Willi's glas crown:A new solution in the dark and shadowed zones of esthetic porcelain restorations.Quintessence Dent Technol,1987,11(4):233
[25]陈秀梅,何国华.修复材料对牙龈组织健康的影响.临床口腔医学杂志,1993,9(1):17
[26]Donovan TE,Cho GC.Soft tissue management with metal2ceramic and all-ceramic restorations.J CalifDent Assoc,1998,26(2):107-112.
[27]Keenan MP,Shillingburg HT Jr,Duncanmson MG Jr et al.Effects of cast gold surface finishing on plaque retention[J].J Prosthet Dent,1980,43(2):168-173.
[28]Johnston JF.Modem Practice in Crown and Bridgy[M].Prosthodontics,3rded Philadelphia:WBSadndersco,1971:23-41.
[29]赵玮,赵云凤.全冠的牙体预备[J].国外医学口腔分册,2003,3(2):152.
[30]Harrison J D,Crown and bridge preparation,design and use[J].Dent Clin North Am 1966,Mar:185-193.
[31]赵要武.金属烤瓷冠修复的基牙预备[J].广东牙病防治,2001,9(1):72.
[32]Preston J D,Rational approach to tooth Preparation for ceramic-metal restorations[J].Dent Clin North Am 1977,21(4):683-698.
[33]徐君伍.口腔修复学[M].4版,北京:人民卫生出版社,2002:27-28.
[34]Schwartz I S.A review of methods and techniques to improve the fit of cast restoration[J].Prosthet Dent,1986,56:279.
[35]Seymour K,Zou L.Assessment of shoulder dimension and angles of porcelain bonded to metal crown preparations.J Prosthet Dent,1996,75(4):406-411.
[36]张壁,程祥荣,钱法汤.金属烤瓷联合全冠在口腔修复的应用.口腔医学纵横,1996,12(1):54-55.
[37]叶剑涛,常少海,陈超杰,等,高金合金与镍铬合金烤瓷冠临床应用效果的比较,口 腔颌面修复学杂志,2002,3(4):227-229.
[38]Lockard MW.A ret respect ive study of pulpal response in vital adult teeth prepared for complete coverage restorations at ultrahigh speed using only air coolant.J Prosthet Dent,2002;88(5):473
[39]M u Y,Zheng D.H istologic study on the pulpal response after complete crown preparation.Hua Xi Kou Q iang Yi Xue Za Zh i,1998;16(2):141.
[40]王昆润,潘义兴.金属烤瓷修复体基牙预备后牙髓血液动力学变化.国外医学口腔医学分册 1996,23(1):58
[41]江南,朱梅,史久成金属烤瓷修复的牙髓评价[J]牙体牙髓牙周病学杂志,2000,10(6):3461
[42]Foster LV.Failed conventional bridge work from general dental prac-tice:clinical aspects and treatments needs of 142 cases[J].Br Dent J,1990,168:199-201.
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