氧化锆全瓷和钴铬合金烤瓷冠修复对基牙牙周指数及致病菌的影响

发布时间：2018-04-29 16:35

  本文选题：氧化锆全瓷冠 + 钴铬合金烤瓷冠　； 参考：《大连医科大学》2017年硕士论文

【摘要】：目的:通过检测不同材料在全冠修复前、后不同时间段龈下菌斑中牙龈卟啉单胞菌(Porphyromonas gingivalis,P.g)、齿垢密螺体(Treponema denticola,T.d)、福赛坦氏菌(Tannerellaforsythensis,T.f)3种细菌检出率,并结合牙周临床指标评价不同类型材料对基牙牙周组织的影响。方法:1.研究对象:选取2015年9月至2016年10月,在辽宁省人民医院口腔科门诊拟行全冠修复治疗的患者,经过入选条件严格筛选后作为实验对象。将其为两组:氧化锆全瓷冠组40例(男19例、女21例)和钴铬合金烤瓷冠组40例(男22例、女18例)。设同颌同名牙(若此牙缺失,以对颌同名牙代替)为组内对照。所有实验对象年龄控制在25-65岁,氧化锆全瓷冠组平均年龄32.60±7.93岁;钴铬合金烤瓷冠组平均年龄33.33±6.44岁,均同意参加本实验,并签定知情同意书。2.方法:采用组间、组内相互对照研究方法,检查并记录受试者牙体预备前及戴全冠后三个月、六个月的观测指标,包括牙周探诊深度(Probing depth,PD)和探诊出血指数(bleeding on probing,BOP)。4-site法收集受试牙龈下菌斑样本,按照磁珠法细菌基因组DNA抽提试剂盒操作步骤提DNA,采用聚合酶链式反应(Polymerase Chain Reaction,PCR),对 P.g、T.d 和 T.f 的目的基因片段进行扩增,取一定量扩增产物加样于1.5%琼脂糖凝胶(含Goldview-I)的加样孔中进行电泳,紫外线观察仪下观察结果。采用SPSS 22.0软件建立数据库并对实验数据进行统计分析,不同材料全冠修复在不同时刻细菌检出率的差异采用χ~2检验。结果:1.全冠修复前:两组在年龄和性别等一般资料,PD、BOP阳性率、P.g、T.d、T.f检出率等临床指标及实验室指标上无统计学差异(P0.05)。2.氧化锆全瓷冠组:实验组修复后三个月、六个月时:PD值,P.g、T.d、T.f的阳性检出率与牙体预备前比较均无统计学不同(P0.05);BOP阳性率与基牙牙体预备前比较均无差异。对照组观察三个月、六个月时,PD值,P.g、T.d、T.f的阳性检出率与之前比较无统计学差异(P0.05);BOP检出率与之前比较均无差异。实验组与对照组比较:修复后三个月、六个月PD值,P.g、T.d、T.f的阳性率均改变较小,无统计学差异(P0.05);与对照组比较,BOP的阳性率无差异。3.钴铬合金烤瓷冠组(PFM):实验组烤瓷冠修复后三个月PD值,BOP阳性率,P.g、T.d、T.f的检出率与牙体预备前比较均有增加,但无统计学差异(P0.05);修复后六个月PD值,BOP阳性率,P.g、T.d、T.f的检出率与修复前比较升高,差异显著(P0.05)。对照组观察三个月、六个月时,PD值,P.g、T.d、T.f的检出率与之前比较变化不大,无统计学差异(P0.05);BOP的检出率与之前比较均无差异。实验组与对照组比较:全冠修复后三个月时PD值,BOP阳性率,P.g、T.d、T.f的阳性检出率,均无统计学差别(P0.05);修复后六个月时PD值,BOP的阳性率,P.g、T.d、T.f阳性检出率,均有增加,有统计学差异(P0.05)。4.钴铬全冠组与氧化锆全冠组:两组之间比较:修复后三个月:钴铬合金全冠组PD值高于氧化锆全冠组,差异显著(P0.05);BOP阳性检出率,P.g、T.d、T.f的检出率与氧化锆全冠比无统计学差异(P0.05)。修复后六个月:PD值,BOP阳性率,P.g、T.d、T.f的阳性检出率均明显高于氧化锆全瓷冠组,差异显著(P0.05)。结论:1.氧化锆全瓷冠修复后三个月、六个月时,基牙牙周组织无明显炎性改变;钴铬合金烤瓷冠修复六个月时,基牙牙周组织呈炎症状态。2.氧化锆全瓷冠修复较钴铬合金烤瓷冠修复更有利于维护基牙牙周组织健康。
[Abstract]:Objective: to detect the detection rate of 3 kinds of bacteria in subgingival plaque (Porphyromonas gingivalis, P.g), Treponema denticola (T.d) and Tannerellaforsythensis (T.f) in the subgingival plaque before and after the restoration of different materials, and to evaluate the different types of materials on the base teeth with the periodontal clinical indexes. The influence of periodontal tissue. Methods: 1. subjects: selected patients who were in the Department of Stomatology of the Department of Stomatology of the Liaoning Provincial People's Hospital from September 2015 to October 2016, after selected conditions were selected as the experimental subjects. They were divided into two groups: 40 cases of zirconia full porcelain crown group (male 19 cases, 21 women) and 40 cobalt chromium alloy crown group 40 cases (male) 22 cases, 18 female cases, the same name teeth of the same jaw (if the tooth is missing, instead of the same teeth of the same jaw) as the group control. The age control of all the subjects was 25-65 years old, the average age of the zirconia full porcelain crown group was 32.60 + 7.93 years old; the average age of the cobalt chromium alloy porcelain crown group was 33.33 + 6.44 years old, all with the Italy addition experiment, and signed the informed consent.2. method: adopt In the group, the intra group control study method was used to check and record the observation indexes of the subjects before and after the three months, six months after the total crown of the subjects, including the Probing depth, PD and the bleeding on probing (BOP).4-site method to collect the samples of the subgingival plaque of the subjects, and the genomic DNA extraction according to the magnetic bead method. DNA, Polymerase Chain Reaction (PCR), was used to amplify the target gene fragments of P.g, T.d and T.f, and a certain amount of amplification products were added to the 1.5% agarose gel (containing Goldview-I) in the sample hole to be electrophoretic, and the results were observed under the ultraviolet observation instrument. The software was established by SPSS 22 software. The statistical analysis of the data was carried out in the database. The difference of bacterial detection rate of the total crown of different materials at different times was tested by ~2 test. Results: before 1. full crown restoration, the two groups had no statistical difference (P0.05).2. oxidation in general data of age and sex, PD, BOP positive rate, P.g, T.d, T.f detection rate and so on. Zr all porcelain crown group: three months after the experimental group, six months after repair, the positive rate of PD, P.g, T.d, T.f was not statistically different from that before the tooth preparation (P0.05). The positive rate of BOP was not different from that before the base tooth preparation. The positive rate of PD, P.g, T.d and T.f was no statistics at three months and six months in the control group. Compared with the control group, the positive rates of PD, P.g, T.d, T.f were all smaller and no statistical difference (P0.05). The positive rate of BOP was no difference between the control group and the control group (P0.05). The positive rate of BOP was no difference between the control group and the control group (P0.05). The positive rate of BOP was not different from the control group (PFM): three months PD after the porcelain crowns were repaired in the experimental group (PFM). The positive rate of BOP, P.g, T.d, T.f increased, but there was no statistical difference (P0.05). The detection rate of BOP positive rate, P.g, T.d and T.f increased in the six months after repair, and the difference was significant (P0.05). In the control group, three months, six months, the detection rate of PD was compared with the previous changes. There was no statistical difference (P0.05); there was no difference in the detection rate of BOP. Compared with the control group, the PD value, BOP positive rate, P.g, T.d, T.f positive detection rate at three months after the crown restoration were not statistically different (P0.05); the positive rate, P.g, T.d, positive detection rates of BOP were increased. Study difference (P0.05).4. cobalt chromium full crown group and zirconia complete crown group: the comparison between the two groups: three months after repair: the PD value of CO Cr alloy whole crown group was higher than that of the whole crown group of zirconia, the difference was significant (P0.05); the positive rate of BOP, the detection rate of P.g, T.d, T.f was not statistically different from that of the total crown of zirconia (P0.05). PD value, BOP positive rate, P.g, The positive rate of T.d and T.f was significantly higher than that of the whole porcelain crown of zirconia, and the difference was significant (P0.05). Conclusion: there was no obvious inflammatory change in the periodontal tissue of the base teeth at three months after the restoration of the 1. zirconia full porcelain crown, and when the cobalt chromium alloy porcelain crown was repaired for six months, the periodontium of the base tooth periodontium was repaired with the cobalt chromium alloy grill compared with the cobalt chromium alloy. Porcelain crown restoration is more conducive to maintaining the health of abutment periodontal tissue.

【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.3
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本文编号：1820718