金属嵌体冠在低<inline-formula id="zhqkyx-20-9-1469-M1"><inline-graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="zhqkyx-20-9-1469-M1.jpg"/></inline-formula>龈距磨牙残冠修复中的应用

谢小飞; 刘芳; 田瑞雪; 尹小旋; 甘红琴; 张凯

doi:10.16766/j.cnki.issn.1674-4152.002625

金属嵌体冠在低龈距磨牙残冠修复中的应用

doi: 10.16766/j.cnki.issn.1674-4152.002625

谢小飞^{1, 2},
刘芳^{1, 2},
田瑞雪^{1, 2},
尹小旋^{1, 2},
甘红琴^{1, 2},
张凯^{1, 2, ,}

1.
蚌埠医学院第一附属医院口腔科，安徽蚌埠 233004
2.
蚌埠医学院口腔医学院，安徽蚌埠 233000

基金项目:

安徽省高校自然科学项目 KJ2021A0790

蚌埠医学院自然科学项目 BYKY2019019ZD

详细信息

通讯作者:
张凯, E-mail: zk29788@163.com

中图分类号: R781.05 R783.3
计量
- 文章访问数: 161
- HTML全文浏览量: 53
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2022-03-04
- 网络出版日期: 2022-11-29

Application of metal endocrown in the restoration of residual crown of low occlusal gingival distance molar

XIE Xiao-fei^{1, 2},
LIU Fang^{1, 2},
TIAN Rui-xue^{1, 2},
YIN Xiao-xuan^{1, 2},
GAN Hong-qin^{1, 2},
ZHANG Kai^{1, 2
, ,}

1.
Department of Stomatology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

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。
- 金属 /
- 嵌体冠 /
- 磨牙 /
- 残冠 /
- 修复
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.
- Metal /
- Endocrown /
- Molar /
- Residual crown /
- Repair

HTML全文

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

下载: 导出CSV

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)

下载: 导出CSV

参考文献(16)

[1]	刘雪梅, 邱晓峰. 不同方法修复磨牙大面积缺损的疗效比较[J]. 河北医科大学学报, 2020, 41(3): 328-331. doi: 10.3969/j.issn.1007-3205.2020.03.019 LIU X M, QIU X F. Comparison of the effects of different methods on repairing large area defects of molars[J]. Journal of Hebei Medical University, 2020, 41(3): 328-331. doi: 10.3969/j.issn.1007-3205.2020.03.019
[2]	马江敏, 朱苑, 张鹏. 儿童年轻恒磨牙根管治疗后三种修复方式耗时与疗效对比[J]. 口腔颌面修复学杂志, 2018, 19(4): 197-200. doi: 10.3969/j.issn.1009-3761.2018.04.002 MA J M, ZHU Y, ZHANG P. Comparison of treartmen time and effects of three restoration methods of young permanent molars of children after RCT[J]. Chinese Journal of Prosthodontics, 2018, 19(4): 197-200. doi: 10.3969/j.issn.1009-3761.2018.04.002
[3]	邹高峰, 常靓, 张梅, 等. E-max全冠与高嵌体修复根管治疗后牙的临床观察[J]. 北京口腔医学, 2021, 29(2): 85-89. https://www.cnki.com.cn/Article/CJFDTOTAL-BJKX202102008.htm ZOU G F, CHANG L, ZHANG M, et al. Clinical study of endodontically treated posterior teeth restored with E-max full crowns or onlays[J]. Beijing Journal of Stomatology, 2021, 29(2): 85-89. https://www.cnki.com.cn/Article/CJFDTOTAL-BJKX202102008.htm
[4]	王军飒, 莫澜, 朱凤节. 全瓷全冠与高嵌体修复低矮磨牙的效果比较[J]. 临床医学, 2021, 41(6): 67-68. https://www.cnki.com.cn/Article/CJFDTOTAL-EBED202106027.htm WANG J S, MO L, ZHU F J. Comparison of the effect of full porcelain crown and onlay in repairing low molars[J]. Clinical Medicine, 2021, 41(6): 67-68. https://www.cnki.com.cn/Article/CJFDTOTAL-EBED202106027.htm
[5]	何文丹. 龈距离不足的磨牙应用两种材质嵌体冠修复的效果分析[J]. 临床口腔医学杂志, 2018, 34(8): 498-501. doi: 10.3969/j.issn.1003-1634.2018.08.015 HE W D. The comparative analysis of two kinds of material endocrown restoration on molars with insufficient occlusal distance[J]. Journal of Clinical Stomatology, 2018, 34(8): 498-501. doi: 10.3969/j.issn.1003-1634.2018.08.015
[6]	张维波, 陈佳龙, 曹颖. 2种全瓷高嵌体修复无髓后牙牙体缺损的对比研究[J]. 中华全科医学, 2020, 18(6): 938-941, 1024. doi: 10.16766/j.cnki.issn.1674-4152.001397 ZHANG W B, CHEN J L, CAO Y. The comparative study on restoring pulpless posterior tooth defect with two kinds of ceramic onlays[J]. Chinese Journal of General Practice, 2020, 18(6): 938-941, 1024. doi: 10.16766/j.cnki.issn.1674-4152.001397
[7]	陈文丽, 谢小飞, 刘芳, 等. 根管治疗后高嵌体与纤维桩核冠修复后牙牙体缺损的临床疗效观察[J]. 中华全科医学, 2021, 19(5): 767-770. doi: 10.16766/j.cnki.issn.1674-4152.001912 CHEN W L, XIE X F, LIU F, et al. Clinical effect of onlay and fibre post-core crown in repairing tooth defect after root canal treatment[J]. Chinese Journal of General Practice, 2021, 19(5): 767-770. doi: 10.16766/j.cnki.issn.1674-4152.001912
[8]	陈智, 陈瑞甜. 髓腔固位冠[J]. 口腔医学研究, 2018, 34(1): 1-5. https://www.cnki.com.cn/Article/CJFDTOTAL-KQYZ201801001.htm CHEN Z, CHEN R T. Medullary cavity retainer crown[J]. Journal of Oral Science Research, 2018, 34(1): 1-5. https://www.cnki.com.cn/Article/CJFDTOTAL-KQYZ201801001.htm
[9]	FAGES M, RAYNAL J, TRAMINI P, et al. Chairside computer-aided design/computer-aided manufacture a11-ceramic crown and endocrown restorations: A 7-year survival rate study[J]. Int J Prosthodont, 2017, 30(6): 556-560.
[10]	BELLEFLAMME M M, GEERTS S O, LOUWETTE M M, et al. No post-no core approach to restore severely damaged posterior teeth: An up to 10-year retrospective study of documented endocrown cases[J]. J Dent, 2017, 63: 1-7.
[11]	王剑. 浅谈嵌体和高嵌体修复的临床应用[J]. 国际口腔医学杂志, 2021, 48(5): 497-505. https://www.cnki.com.cn/Article/CJFDTOTAL-GWKQ202105001.htm WANG J. Research progress and clinical application of inlays and onlays[J]. International Journal of Stomatology, 2021, 48(5): 497-505. https://www.cnki.com.cn/Article/CJFDTOTAL-GWKQ202105001.htm
[12]	ELASHMAWY Y, ELSHAHAWY W, SEDDIK M, et al. Influence of fatigue loading on fracture resistance of endodontically treated teeth restored with endocrowns[J]. J Prosthodont Res, 2020, 65(1): 78-85.
[13]	吴娴, 丁凤, 许建辉. 三种嵌体冠修短冠磨牙的临床研究[J]. 临床医药实践, 2018, 27(10): 723-725. WU X, DING F, XU J H. Clinical study on the restoration effect of three kinds of inlay crown on the short coronal molars[J]. Proceeding of Clinical Medicine, 2018, 27(10): 723-725.
[14]	包旭东. 椅旁计算机辅助设计与辅助制作嵌体冠粘接修复大面积缺损根管治疗牙的利与弊[J]. 中华口腔医学杂志, 2018, 53(4): 221-225. BAO X D. Advantages and disadvantages of endocrown restorations of endodontically treated teeth with large coronal destruction[J]. Chinese Journal of Stomatology, 2018, 53(4): 221-225.
[15]	尹小旋, 谢小飞. 嵌体冠的临床应用研究进展[J]. 齐齐哈尔医学院学报, 2021, 42(22): 2002-2006. https://www.cnki.com.cn/Article/CJFDTOTAL-QQHB202122017.htm YIN X X, XIE X F. Advances in clinical application of inlay crowns[J]. Journal of Qiqihar Medical University, 2021, 42(22): 2002-2006. https://www.cnki.com.cn/Article/CJFDTOTAL-QQHB202122017.htm
[16]	田霞, 宫文红, 张雪健, 等. 二硅酸锂基玻璃陶瓷高嵌体修复下颌第一磨牙抗折强度的体外研究[J]. 临床口腔医学杂志, 2021, 37(6): 332-335. https://www.cnki.com.cn/Article/CJFDTOTAL-LCKY202106004.htm TIAN X, GONG W H, ZHANG X J, et al. In vitro study of effects of CAD/CAM lithium disilicate glass ceramic inlays and full crown restoration on fracture resistance of mandibular first molar after root canal therapy[J]. Journal of Clinical Stomatology, 2021, 37(6): 332-335. https://www.cnki.com.cn/Article/CJFDTOTAL-LCKY202106004.htm