数字化椅旁制作髓腔固位嵌体应用于牙体缺损修复的临床效果观察附20例临床病例汇报

发布时间：2018-04-18 13:35

本文选题：髓高嵌体 + 髓超嵌体　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:本研究应用Cerec AC椅旁即刻全瓷修复系统设计制作髓腔固位嵌体用于修复根管治疗后的后牙牙体缺损,并对其临床效果进行观察和分析。方法:本研究运用Sirona公司Cerec AC椅旁即刻全瓷修复系统制作髓腔固位嵌体修复后牙缺损106例。所选病例均经过我科医师进行完善根管治疗,经牙体预备后,使用Cerec AC椅旁即刻全瓷修复系统进行口内扫描、设计,对长石质陶瓷瓷块进行研磨和制作,经试戴、调后进行即刻粘接。对所有病例进行2年随访,由两位医师按照改良USPHS标准对髓腔固位嵌体进行检查和评价,并由患者填写满意度调查表;106个髓腔固位嵌体中69个为髓高嵌体,37个为髓超嵌体,使用Cerec AC设计软件的测量功能对所有106个修复体进行测量,测量每个髓腔固位嵌体修复体面最小厚度,并将其分为小于1mm组,1mm-1.5mm组,大于1.5mm组;对保留部分牙壁制作髓高嵌体的69个病例,测量其基牙余留牙壁最小厚度,并将其分为大于1mm小于1.5mm组,1.5mm-2mm组,大于2mm组,随访并统计各组失败病例数,运用SPSS 24软件对其进行统计分析。结果:本研究中106个全瓷髓腔固位嵌体两年成功率为92.5%。其中全瓷髓高嵌体的两年成功率为:92.8%,全瓷髓超嵌体的两年成功率为91.9%。失败的8例中,修复体脱落3例,修复体折裂4例,基牙牙折1例。修复体折裂病例中修复体厚度小于1mm组3例,修复体厚度1mm-1.5mm组1例,修复体厚度大于1.5mm组无折裂发生;基牙牙折病例中余留牙壁厚度大于1mm小于1.5mm组无牙折裂发生,1.5mm-2mm组1例,大于2mm组无牙折裂发生。根据改良USPHS标准对本研究中2年后随访的105个修复体进行测评,可见修复后2年,髓高嵌体边缘适合性达到A标准的占97%,B标准的为3%;修复体完整度达到A标准的占97%;B标准的为3%;牙龈健康达到A标准的占96%,达到B标准的占4%;边缘染色达到A标准的占97%,达到B标准的占3%。髓超嵌体边缘适合性达到A标准的占92%,B标准的为8%;修复体完整度达到A标准的占92%;B标准的为8%;牙龈健康达到A标准的占92%,达到B标准的占8%;边缘染色达到A标准的占97%,达到B标准的占3%。。患者对此次修复的满意度调查结果可见有94%的患者对修复体总体感到满意,其中73%患者感到非常满意;在修复体外形、颜色、舒适度和费用方面,患者对使用舒适度方面的满意度最高,有90%的患者感到非常满意。结论:Cerec AC系统设计制作的髓腔固位嵌体修复根管治疗后后牙牙体缺损,临床效果可靠,患者满意度高。长石质陶瓷修复体面厚度应大于1.5mm,基牙余留牙壁厚度对修复成功率短期无影响。
[Abstract]:Objective: to study the application of Cerec AC immediate porcelain restoration system to the restoration of posterior tooth defect after root canal therapy, and to observe and analyze its clinical effect.Methods: in this study, 106 cases of posterior tooth defect were repaired with Sirona Cerec AC immediate porcelain restoration system.All the selected cases were treated with perfect root canal therapy by our doctor. After tooth preparation, Cerec AC chair immediate all ceramic restoration system was used for oral scanning, design, grinding and making of feldspathic ceramic pieces.After adjusting, make an immediate bonding.All the patients were followed up for 2 years. According to the modified USPHS standard, two physicians examined and evaluated the intramedullary retention inlay, and the patients filled in the satisfaction questionnaire, 69 of 106 cases were myelohyperinlay and 37 were medullary hyperinlay.All 106 prostheses were measured by the Cerec AC design software. The minimum thickness of each inlay was measured and divided into groups smaller than 1 mm ~ 1.5 mm in 1mm group and larger than that in 1.5mm group.The minimal thickness of residual teeth was measured in 69 cases of pulp hyperinlay with partial preservation of the tooth wall, and was divided into two groups: 1mm larger than 1.5 mm m ~ (-2) mm in 1.5mm group, larger than 2mm group, followed up and counted the number of failure cases in each group.SPSS 24 software was used to make statistical analysis.Results: the two-year success rate of 106 all-ceramic retention inlays was 92. 5%.The two-year success rate of all-ceramic pulp hyperinlay was 92. 8%, and that of all porcelain pulp superinlay was 91.9%.Of the 8 cases, 3 cases were lost, 4 cases were broken, and 1 case was broken of abutment teeth.The thickness of restoration was less than that of 1mm group in 3 cases, 1mm-1.5mm group in 1 case, the thickness of restoration was greater than that in 1.5mm group, and in abutment tooth fracture group, the thickness of residual tooth wall was greater than that of 1mm group, and 1 case in group 1. 5 mm ~ 2 mm in 1mm group, and 1 case in group 1 in 1mm-1.5mm group, and 1 case in group 1 in which the thickness of residual tooth wall was greater than that in 1mm group.No tooth fracture occurred in 2mm group.According to the modified USPHS criteria, 105 prostheses were evaluated after 2 years follow-up in this study.The margin fitness of medullary hyperinlay was up to 97B standard, the integrity of restoration reached A standard and the ratio of restoration integrity to A standard was 3. The proportion of gingival health to A standard was 96, and that to B standard was 4 percent. Edge staining was to A standard.The percentage of 97 percent is 97, and that of the B standard is three.92B standard for marginal fitness of medullary hyperinlay, 8 for restoration integrity and 92b standard for A, 92 for gingival health and 8 for B standard, and 8 for edge staining and A standard for gingival health, and 8 for A standard for gingival health and 8 for A standard for marginal staining.The proportion of B's is 97, and the proportion of B's is three.The survey of patients' satisfaction with the restoration showed that 94% of the patients were satisfied with the prosthesis in general, and 73% of the patients were very satisfied with the prosthesis, in terms of shape, color, comfort and cost of the restoration,Patients had the highest satisfaction with comfort, with 90% feeling very satisfied.Conclusion the pulp cavity retention inlay designed by Cerec AC system is effective and satisfactory in the treatment of posterior tooth defect.The decent thickness of feldspar ceramic restoration should be more than 1.5 mm, and the thickness of residual tooth wall of abutment had no effect on the success rate.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.3

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