不同铸瓷高嵌体边缘修复无髓磨牙的临床疗效分析
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摘要
目的:探讨不同铸瓷高嵌体边缘修复无髓磨牙的临床疗效。方法:选取2014年1月～2016年10月在我院牙科进行根管治疗的96例患者(151颗无髓磨牙)为研究对象;轻度缺损(45例)、中度缺损(58例)、重度缺损(48例)3组;根据不同的边缘设计可分为斜面组(46例)、凹形肩台组(49例)、平面对接组(56例)。随访2年,记录3组患牙不同缺损情况下的修复和存活情况。结果:患牙轻度缺损,平面对接组、斜面组、凹形肩台组成功率分别为100%、100%、93.33%,存活率均为100%。中度缺损,平面对接组、斜面组、凹形肩台组成功率分别为95.24%、88.24%、95.00%,存活率分别为100%、94.12%、95.00%。重度缺损,平面对接组、斜面组、凹形肩台组成功率分别为95.24%、69.23%、78.57%,存活率分别为100%、84.62%、85.71%。不同程度缺损情况下,3组患牙修复成功率和存活率比较,差异均无统计学意义(P>0.05)。治疗后各个时间段均可能出现修复失败,以高嵌体折断、冠折不可修复最常见,患牙重度缺损时斜面组失败率最高。结论:对根管治疗后存在轻、中、重度牙体缺损的无髓磨牙,采用边缘设计为平面对接式的高嵌体进行修复均可达到满意的治疗效果。
Objective:To explore the clinical efficacy of different margins of cast ceramic onlays in the repair of pulp-less molars.Methods:Totally 96 patients(151 pulp-less molars)who underwent root canal therapy in department of dentistry of our hospital from January 2014 to October 2016 were selected as subjects.They were divided into three groups of mild defect(45 cases),moderate defect(58 cases)and severe defect(48 cases),and divided into oblique plane group(46 cases),concave abutment group(49 cases)and plane docking group(56 cases)according to different margin designs.At 2 years of follow-up,the repair and survival of affected teeth under varying degrees of defects were recorded in the three groups.Results:In the case of affected teeth with mild defect,the success rates in plane docking group,oblique plane group and concave abutment group were 100%,100% and 93.33% respectively,and the survival rates all were 100%.In the case of affected teeth with moderate defect,the success rates in plane docking group,oblique plane group and concave abutment group were 95.24%,88.24% and 95.00% respectively,and the survival rates were 100%,94.12% and 95.00% respectively.In the case of affected teeth with severe defect,the success rates in plane docking group,oblique plane group and concave abutment group were 95.24%,69.23% and 78.57%,and the survival rates were 100%,84.62% and 85.71% respectively.There were no significant differences in the repair success rate and survival rate of affected teeth in three groups under different degrees of defects respectively(P>0.05).Repair failure might occur at various time periods after treatment,and it was most common for high inlay fracture and crown fracture,and the failure rate of affected teeth with severe defect was the highest in oblique plane group.Conclusion:For pulp-less molars with mild,moderate and severe tooth defects after root canal therapy,onlays with plane docking margin design for repair can achieve satisfactory treatment effects.
Objective:To explore the clinical efficacy of different margins of cast ceramic onlays in the repair of pulp-less molars.Methods:Totally 96 patients(151 pulp-less molars)who underwent root canal therapy in department of dentistry of our hospital from January 2014 to October 2016 were selected as subjects.They were divided into three groups of mild defect(45 cases),moderate defect(58 cases)and severe defect(48 cases),and divided into oblique plane group(46 cases),concave abutment group(49 cases)and plane docking group(56 cases)according to different margin designs.At 2 years of follow-up,the repair and survival of affected teeth under varying degrees of defects were recorded in the three groups.Results:In the case of affected teeth with mild defect,the success rates in plane docking group,oblique plane group and concave abutment group were 100%,100% and 93.33% respectively,and the survival rates all were 100%.In the case of affected teeth with moderate defect,the success rates in plane docking group,oblique plane group and concave abutment group were 95.24%,88.24% and 95.00% respectively,and the survival rates were 100%,94.12% and 95.00% respectively.In the case of affected teeth with severe defect,the success rates in plane docking group,oblique plane group and concave abutment group were 95.24%,69.23% and 78.57%,and the survival rates were 100%,84.62% and 85.71% respectively.There were no significant differences in the repair success rate and survival rate of affected teeth in three groups under different degrees of defects respectively(P>0.05).Repair failure might occur at various time periods after treatment,and it was most common for high inlay fracture and crown fracture,and the failure rate of affected teeth with severe defect was the highest in oblique plane group.Conclusion:For pulp-less molars with mild,moderate and severe tooth defects after root canal therapy,onlays with plane docking margin design for repair can achieve satisfactory treatment effects.
引文
[1]林青,杜毅.青少年恒磨牙根管治疗后高嵌体修复的疗效观察[J].实用口腔医学杂志,2017,33(5):707-709.
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[3]王之铭,郭靖,赵彤,等.不同边缘设计对钴铬合金烤瓷髓腔固位冠微渗漏影响的研究[J].中华老年口腔医学杂志,2017,15(1):33-36.
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[6]强卫林,李雨轩,刘刚,等.3种边缘设计铸瓷高嵌体修复不同程度缺损无髓磨牙的3年对比研究[J].华西口腔医学杂志,2018,36(5):493-497.
[7]杨雪薇,张少锋,李岩,等.255件椅旁IPSe.maxCAD全瓷修复体1年临床疗效观察[J].牙体牙髓牙周病学杂志,2017,27(3):150-153.
[8]曹桂珍,郭大伟,李亚芹,等.全瓷高嵌体用于根管治疗后牙牙体修复的临床观察[J].口腔颌面修复学杂志,2017,18(2):87-92.
[9]杨平.CAD/CAM高嵌体修复术治疗后牙牙体大面积缺损的远期疗效观察[J].成都医学院学报,2017,12(6):715-718.
[10]覃小凤,姚颖冰,许胜,等.不同预备宽度微创铸瓷贴面修复抗折性能的比较研究[J].临床口腔医学杂志,2017,33(11):650-652.
[11]陈岗,陈志飞,顾卫平,等.不同边缘设计椅旁CAD/CAM全瓷高嵌体修复的对比研究[J].口腔医学,2015,35(7):550-552.
[12]周进茹,陈西文,朱智敏,等.全瓷冠与高嵌体用于修复邻(牙合)面缺损根管治疗后下颌磨牙抗折强度对比研究[J].中国实用口腔科杂志,2017,10(1):26-30.
[13]张孝霞,韩丁,朱庆林,等.大面积缺损的下颌第一前磨牙桩核冠与高嵌体修复的三维有限元分析[J].牙体牙髓牙周病学杂志,2018,28(5):265-269.
[14]李学英,王根平,孙博,等.树脂直接粘结与嵌体间接粘结修复对根管治疗牙抗折能力的效果比较[J].实用临床医药杂志,2018,22(13):80-82,86.
[2]杨乐,顾仓临,朱锦跃,等.全瓷高嵌体修复后牙多面龋齿32例[J].蚌埠医学院学报,2017,42(12):1648-1649.
[3]王之铭,郭靖,赵彤,等.不同边缘设计对钴铬合金烤瓷髓腔固位冠微渗漏影响的研究[J].中华老年口腔医学杂志,2017,15(1):33-36.
[4]李学盛,郭靖,王潇宇,等.钴铬合金烤瓷髓腔固位冠边缘设计对内冠适合性影响的研究[J].中华老年口腔医学杂志,2016,14(2):92-95.
[5]郭靖,王潇宇,李学盛,等.不同边缘设计的髓腔固位冠修复下颌前磨牙的应力分析[J].南方医科大学学报,2016,36(2):200-204.
[6]强卫林,李雨轩,刘刚,等.3种边缘设计铸瓷高嵌体修复不同程度缺损无髓磨牙的3年对比研究[J].华西口腔医学杂志,2018,36(5):493-497.
[7]杨雪薇,张少锋,李岩,等.255件椅旁IPSe.maxCAD全瓷修复体1年临床疗效观察[J].牙体牙髓牙周病学杂志,2017,27(3):150-153.
[8]曹桂珍,郭大伟,李亚芹,等.全瓷高嵌体用于根管治疗后牙牙体修复的临床观察[J].口腔颌面修复学杂志,2017,18(2):87-92.
[9]杨平.CAD/CAM高嵌体修复术治疗后牙牙体大面积缺损的远期疗效观察[J].成都医学院学报,2017,12(6):715-718.
[10]覃小凤,姚颖冰,许胜,等.不同预备宽度微创铸瓷贴面修复抗折性能的比较研究[J].临床口腔医学杂志,2017,33(11):650-652.
[11]陈岗,陈志飞,顾卫平,等.不同边缘设计椅旁CAD/CAM全瓷高嵌体修复的对比研究[J].口腔医学,2015,35(7):550-552.
[12]周进茹,陈西文,朱智敏,等.全瓷冠与高嵌体用于修复邻(牙合)面缺损根管治疗后下颌磨牙抗折强度对比研究[J].中国实用口腔科杂志,2017,10(1):26-30.
[13]张孝霞,韩丁,朱庆林,等.大面积缺损的下颌第一前磨牙桩核冠与高嵌体修复的三维有限元分析[J].牙体牙髓牙周病学杂志,2018,28(5):265-269.
[14]李学英,王根平,孙博,等.树脂直接粘结与嵌体间接粘结修复对根管治疗牙抗折能力的效果比较[J].实用临床医药杂志,2018,22(13):80-82,86.