Application of metal endocrown in the restoration of residual crown of low occlusal gingival distance molar
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摘要:
目的 探索金属嵌体冠在 龈距不足的磨牙保存修复中的应用效果。方法 选择2015年1月—2020年5月在蚌埠医学院第一附属医院口腔科就诊的患者作为研究对象,纳入 龈距为1~3 mm的磨牙残冠患者50例,共计50颗患牙,包括男性28例28颗患牙,女性22例22颗患牙,年龄为18~60岁,平均年龄为42岁。所有患者进行完善的根管治疗,然后进行牙体预备,利用髓腔固位,制作纯钛金属嵌体冠。于修复体粘接后1、6、12、18个月时复查,参考美国公共卫生署对牙科修复体的评价标准,观察修复体有无松动脱落、修复体或牙体有无折裂、修复体边缘密合性、有无继发龋、牙龈情况、有无食物嵌塞等情况并记录。结果 50例患者均未失访,随访1个月时各项观察指标均无异常,随访期内无牙体或修复体折裂发生,第5、9、16个月分别出现嵌体冠脱落病例。此外,6个月复查时出现1例边缘不密合、2例牙龈炎,其中1例牙龈炎伴发食物嵌塞;12个月时累计出现2例边缘不密合,其中1例边缘不密合伴发继发龋,3例牙龈炎,其中2例牙龈炎伴发食物嵌塞;18个月时累计出现3例边缘不密合,3例边缘不密合均伴发继发龋,4例牙龈炎,其中2例牙龈炎伴发食物嵌塞。 结论 金属嵌体冠在 龈距不足的磨牙修复中应用效果满意。Abstract:Objective To explore the effect of metal endocrown in the preservation and restoration of molar with insufficient gingival distance. Methods Patients from the Department of Stomatology of the First Affiliated Hospital of the Bengbu Medical College were selected for the study. The main criteria included 50 molars with 1-3 mm gingival distance, 50 molars with 50 teeth, including 28 males with 28 teeth and 22 females with 22 teeth (age range=18-60 years; average=42 years). After complete root-canal treatment, the tooth was prepared, a pure titanium inlay crown was prepared using the pulp cavity, and re-examination was conducted 1, 6, 12, and 18 months after the restoration was bonded (in reference to the United States Public Health Service evaluation criteria for dental restorations). The loosening and falling off of the prosthesis, fracture of the prosthesis or tooth, marginal tightness, secondary caries, gingival condition, and food impaction were observed and recorded. Results All 50 patients did not lose the follow-up, and all observation indices were normal during 1 month follow-up. During the follow-up period, no tooth or prosthesis fracture occurred, and the inlay crown fell off at the 5th, 9th, and 16th months, respectively. We found one case of marginal misfit, two cases of gingivitis, and one case of gingivitis with food impaction in 6 months. At 12 months, we found 2 cases of marginal misfit, 1 of marginal misfit with secondary caries, 3 of gingivitis, and 2 of gingivitis with food impaction. At 18 months, we found 3 cases of marginal misfit, 3 of marginal misfit with secondary caries, 4 of gingivitis, and 2 of gingivitis with food impaction. Conclusion The application of metal endocrown in the restoration of molars with insufficient gingival distance is satisfactory. -
Key words:
- Metal /
- Endocrown /
- Molar /
- Residual crown /
- Repair
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表 1 磨牙残冠嵌体冠修复的临床评价指标
Table 1. Clinical evaluation index of molar residual crown inlay crown restoration
评价指标 级别 评价内容 修复体松动脱落 A 修复体无松动或脱落现象 B 修复体出现松动或脱落现象 修复体或牙体折裂 A 修复体或牙体无折裂现象 B 修复体或牙体出现折裂现象 继发龋 A 牙体颈部完好,探诊无明显的窝洞和空虚 B 颈部牙体探诊时有小窝洞存在,X线片示有少许阴影 C 颈部牙体探诊时有窝洞、空虚,X线片示有明显暗影 边缘密合性 A 修复体边缘与牙体接触良好,探针检查无肩台感,不挂探针 B 修复体边缘与牙体接触欠佳,挂探针 C 修复体边缘与牙体接触不良,探针能插入冠与牙体之间 牙龈情况 A 牙龈组织健康 B 牙龈出血,点彩消失,探诊有出血 C 牙龈明显红肿,指压出血 食物嵌塞 A 修复体邻面接触良好,无嵌塞现象 B 修复体邻面外形欠佳,有轻度嵌塞 C 修复体邻面接触不良,有重度嵌塞 表 2 磨牙残冠嵌体冠修复的临床评价结果[例(%)]
Table 2. Clinical evaluation of molar residual crown inlay crown restoration [cases (%)]
项目 级别 1个月 6个月 12个月 18个月 修复体松动脱落 A 50(100.0) 49(98.0) 48(96.0) 47(94.0) B 0 1(2.0) 2(4.0) 3(6.0) 修复体或牙体折裂 A 50(100.0) 50(100.0) 50(100.0) 50(100.0) B 0 0 0 0 继发龋 A 50(100.0) 50(100.0) 49(98.0) 47(94.0) B 0 0 1(2.0) 2(4.0) C 0 0 0 1(2.0) 边缘密合性 A 50(100.0) 49(98.0) 48(96.0) 47(94.0) B 0 1(2.0) 1(2.0) 2(4.0) C 0 0 1(2.0) 1(2.0) 牙龈情况 A 50(100.0) 48(96.0) 47(94.0) 46(92.0) B 0 1(2.0) 2(4.0) 2(4.0) C 0 1(2.0) 1(2.0) 2(4.0) 食物嵌塞 A 50(100.0) 49(98.0) 48(96.0) 48(96.0) B 0 1(2.0) 1(2.0) 1(2.0) C 0 0 1(2.0) 1(2.0) -
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