2种不同覆盖范围全瓷高嵌体对根管治疗后磨牙缺损修复的疗效评价

于健; 徐国超; 肖佳灵

doi:10.16766/j.cnki.issn.1674-4152.002269

2种不同覆盖范围全瓷高嵌体对根管治疗后磨牙缺损修复的疗效评价

doi: 10.16766/j.cnki.issn.1674-4152.002269

浙江医院口腔科，浙江杭州 310030

基金项目:

浙江省自然科学基金项目 LQ20H140003

详细信息

通讯作者:
肖佳灵，E-mail：xiaojlgenius@126.com

中图分类号: R783.4 R781.3
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- 文章访问数: 434
- HTML全文浏览量: 270
- PDF下载量: 7
- 被引次数: 0
出版历程
- 收稿日期: 2020-05-02
- 网络出版日期: 2022-03-03

Effect evaluation of ceramic onlays on endodontically treated molars restored with partical and all coverage

Department of Stomatology, Zhejiang Hospital, Hangzhou, Zhejiang 310030, China

摘要

摘要: 目的比较根管治疗后2种不同面覆盖范围全瓷高嵌体修复磨牙的临床效果。方法选择2016年12月—2017年12月间在浙江医院口腔科行根管治疗后选择铸瓷高嵌体修复的92例患者的105颗磨牙为研究对象。通过掷硬币随机分为部分面覆盖组和全面覆盖组。按修复治疗完成顺序，在高嵌体粘接完成后的6、12、18、24个月进行为期2年的定期随访，参照改良USPHS标准进行修复体临床评估。比较组内和组间随时间推移评价项目优秀率的差异，均采用广义线性混合效应模型进行分析；比较同一时间点同一评价项目优秀率组间差异，采用χ²检验进行。结果组内比较中，AC组牙龈健康状况优秀率逐渐下降且差异有统计学意义(P＜0.05)；PC组修复体完整度、修复体边缘密合性、牙体完整度和继发龋优秀率逐渐下降且差异有统计学意义(均P＜0.05)。组间随时间比较中，AC组和PC组在24个月时，牙体完整度和继发龋优秀率差异有统计学意义(均P＜0.05)。其余评价项目同时间点组间两两比较差异均无统计学意义(均P＞0.05)。结论全面覆盖高嵌体综合表现良好，是根管治疗后轻、中度磨牙缺损修复的良好选择。期待全面覆盖高嵌体相比部分牙合面覆盖高嵌体修复根管治疗后磨牙缺损在长期临床使用过程中会有更好的表现。
- 牙体缺损 /
- 磨牙 /
- 高嵌体 /
- 部分面覆盖 /
- 全面覆盖
Abstract: Objective The aim of the study is to compare the clinical effect of ceramic onlays with two different coverages to restore root canal treated molars. Methods The sample of 105 endodontically treated molars restored by ceramic onlays were collected from 92 patients seen in Department of Stomatology, Zhejiang Hospital from December 2016 to December 2017. The 105 molars were randomly divided into partial coverage group and all coverage group by tossing a coin. After complete restoration procedures, the molars were evaluated in accordance with the modified United States Public Health Service criteria at 6-month, 12-month, 18-month and 24-month recalls. The statistical analyses of within group and between group changing over time differences of each criteria were carried out using Generalized Linear Mixed Model(GLMM). The between group differences at the same time point recall were analyzed by chi-square test. Results For within group comparison, over time, all coverage (AC) group demonstrated significant decreased of gingiva health rate(P < 0.05); partial coverage (PC) group showed dramatic decrease scale in terms of restoration integrity, marginal adaptation, tooth integrity and secondary caries(all P < 0.05). As for between group comparison, AC and PC groups showed significant differences in tooth integrity and secondary caries at 24 month after onlay insertion(all P < 0.05). The coverage types didn't affect other clinical effect criteria at all these time points (all P > 0.05). In addition, there is no interaction between time and group(all P > 0.05). Conclusion Statistical analysis showed that the all coverage onlay has good comprehensive performance. It is a better choice to restore mild to moderate molar defect after root canal therapy. It is reasonable to expect that all coverage onlay will improve the restoration effect on endodontically treated molars in a long-term clinical use when compared to partial coverage onlay.
- Tooth defect /
- Molar /
- Onlay /
- Partial coverage /
- All coverage

HTML全文

表 1 E-MAX铸瓷高嵌体改良USPHS临床评价标准

评价项目	级别	特点
修复体完整度	A	修复体完整性良好
	B	修复体有小缺损，不影响使用
	C	修复体折裂或脱落
修复体边缘密合性	A	探针和肉眼均不能检测出间隙
	B	探针探有间隙，肉眼可见超出或不足的边缘，无牙本质或基底材料暴露
	C	探针探有间隙，肉眼可见超出或不足的边缘，有牙本质或基底材料暴露
牙体完整度	A	牙体硬组织完整无缺损
	B	牙体硬组织有不影响功能的裂纹或缺损
	C	牙体硬组织有影响功能的缺损或折裂
牙龈健康状况	A	牙龈健康
	B	有轻微牙龈炎症，探诊有少量出现及轻度龈萎缩，但不影响美观
	C	戴入后有明显牙龈红肿、出血、牙周袋加深及影响美观的牙龈萎缩
邻接关系	A	与邻牙邻接关系好，无食物嵌塞
	B	与邻牙邻接关系松，形成食物嵌塞
继发龋	A	修复体边缘无继发龋
	B	修复体边缘可探及继发龋

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表 2 改良USPHS临床标准评估E-MAX铸瓷高嵌体修复结果比较[例(%)]

组别	时间	修复体完整度			修复体边缘密合性			牙体完整度
组别	时间	A	B	C	A	B	C	A	B	C
AC	6个月	58(100.0)	0	0	58(100.0)	0	0	58(100.0)	0	0
	12个月	57(98.3)	0	1(1.7)	57(98.3)	1(1.7)	0	57(98.3)	1(1.7)	0
	18个月	57(98.3)	0	1(1.7)	57(98.3)	1(1.7)	0	56(96.6)	2(3.4)	0
	24个月	57(98.3)	0	1(1.7)	57(98.3)	1(1.7)	0	56(96.6)^c	2(3.4)	0
PC	6个月	47(100.0)^a	0	0	47(100.0)^a	0	0	47(100.0)^ad	0	0
	12个月	46(97.9)	1(2.1)	0	46(97.9)	1(2.1)	0	45(95.7)^a	2(4.3)	0
	18个月	46(97.9)	1(2.1)	0	44(93.6)	3(6.4)	0	42(89.4)^b	4(8.5)	1(2.1)
	24个月	43(91.5)^b	3(6.4)	1(2.1)	42(89.4)^b	5(10.6)	0	39(82.9)^bef	6(12.8)	2(4.3)

组别	时间	牙龈健康状况			邻接关系			继发龋
组别	时间	A	B	C	A		B	A		B
AC	6个月	58(100.0)^a	0	0	58(100.0)		0	58(100.0)		0
	12个月	56(96.6)	2(3.4)	0	56(96.6)		2(3.4)	58(100.0)		0
	18个月	55(94.8)	3(5.2)	0	56(96.6)		2(3.4)	58(100.0)		0
	24个月	54(93.1)^b	4(6.9)	0	56(96.6)		2(3.4)	58(100.0)^c		0
PC	6个月	47(100.0)	0	0	47(100.0)		0	47(100.0)^a		0
	12个月	46(97.9)	1(2.1)	0	47(100.0)		0	47(100.0)^a		0
	18个月	46(97.9)	1(2.1)	0	47(100.0)		0	44(93.6)		3(6.4)
	24个月	45(95.7)	2(4.3)	0	46(97.9)		1(2.1)	43(91.5)^bef		4(8.5)
注：与同组24个月比较，^aP＜0.05；与同组18个月比较，^dP＜0.05；与同组12个月比较，^eP＜0.05；与同组6个月比较，^bP＜0.05。与同时间点PC组比较，^cP＜0.05；与同时间点AC组比较，^fP＜0.05。

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