纤维桩用于年轻患者恒前牙冠折再接的过渡性修复

发布时间：2018-04-24 11:21

  本文选题：年轻患者恒前牙 + 冠折　； 参考：《浙江大学》2014年硕士论文

【摘要】：目的： 研究年轻患者恒前牙冠折后使用纤维桩连接粘结断冠的过渡性修复的临床疗效,探讨影响断冠再接效果的因素。 方法： 110例(135颗)冠折断端保留完整的年轻患者恒前牙冠折患者分为直接粘结组(26例,30颗)及纤维桩粘结组(84例,105颗),纤维桩粘结组再按门诊就诊顺序号随机分成LuxaCore组和RelyX Unicem组,其中LuxaCore组(42例,53颗)再按折断部位位于中1/3或颈1/3处折断分为中1/3折断组(19例,24颗)和颈1/3折断组(23例,29颗),RelyX Unicem组(42例,52颗)再按折断部位分为中1/3折断组(20例,23颗)和颈1/3折断组(22例,29颗)；另67例(77颗牙)冠折断端缺失的年轻患者恒前牙冠折患者纳入纤维桩+树脂修复组做为对比参照。直接粘结组采用直接粘结再接自体断冠,纤维桩粘结组采用纤维桩连接再接自体断冠,纤维桩+树脂修复组采用纤维桩+树脂修复断冠,经过6个月至2年以上的临床随诊观察至成年后改为永久性修复。过渡性修复后及永久性修复前对患者采用自制满意度评价量表进行满度度评价并进行永久性修复的意向调查。对选择不去除粘结断端而直接牙备后全冠永久性修复的患者继续随访观察修复效果。 结果： 1年内LuxaCore组和RelyX Unicem组二组成功率均为100%,高于直接粘结组的93.33%,差异有统计学意义(卡方检验,x2=7.1053,P0.05)。LuxaCore组1年～2年的成功率为92.86%,RelyX Unicem组为92.68%,均高于直接粘结组的73.91%,差异有统计学意义(卡方检验,x2=6.3803,P0.05)。LuxaCore组2年以上的成功率为84.62%,RelyX Unicem组为81.82%,均高于直接粘结组的53.33%,两者比较差异有统计学意义(卡方检验,x2=6.033,P0.05)。纤维桩粘结组中的中1/3折断组再接成功率高于颈1/3折断组,但两者比较差异无统计学意义。纤维桩粘结组中选择不去除粘结断端而直接牙备后全冠永久性修复21例,失败1例,失败率4.76%,与纤维桩+树脂修复组失败率无差异。 即刻修复满意度调查提示纤维桩粘结组满意度评分为8.41±1.41,高于直接粘结组的7.67+2.09和纤维桩+树脂修复组的6.58±1.37,差异有统计学意义(t检验,P0.05)。长期满意度调查提示纤维桩粘结组满意度评分为6.15±1.76,高于直接粘结组的4.58±2.27和纤维桩+树脂修复组的4.30±1.35,差异有统计学意义(t检验,P0.01)。改为永久性修复的意向进行调查结果表明原修复体美观,功能良好是不愿改为永久性修复的主要原因,其中纤维桩粘结组比例最高,达72.97%,高于纤维桩+树脂修复组55.81%。 失败病例影响因素分析中,在咬合关系因素上,直接粘结组中正常咬合病例的失败率低于深覆合覆盖病例,两者比较差异有统计学意义(卡方检验,x2=6.2382,P0.05)。在牙根发育情况因素上,纤维桩粘结组中牙根未发育完成病例的失败率高于已完成病例,两者比较差异有统计学意义(卡方检验,x2=6.0287,P0.05)。在外伤牙松动情况因素上,纤维桩粘结组中Ⅰ°松动病例的失败率高于不松动病例,两者比较差异有统计学意义(卡方检验,x2=5.564,P0.05)。在折断线位置因素上,直接粘结组中折断线位置位于龈上的失败率低于位于龈下病例,两者比较差异有统计学意义(卡方检验,x2=5.5767,P0.05),纤维桩粘结组中折断线位置位于龈上的失败率低于位于龈下病例,两者比较差异有统计学意义(卡方检验,x2=25.556,P0.01)。 结论： 使用纤维桩连接自体牙冠过渡性修复年轻患者恒前牙冠,疗效肯定,优于直接粘结及纤维桩+树脂修复,患者即刻及长期满意度高,又不影响后期的永久修复,是一种良好的过渡性修复方法；修复过程应注意折断部位、咬合关系、牙根发育情况、牙松动情况、折断线位置对修复成功率的影响。
[Abstract]:Purpose :

To study the clinical curative effect of the transitional repair using fiber - pile to bond the broken crown after the anterior tooth crown was folded in young patients , and the factors influencing the effect of crown re - grafting were discussed .

Method :

In 110 cases ( 135 teeth ) , the intact young patients were divided into direct bonding group ( 26 cases , 30 teeth ) and fiber pile bonding group ( 84 cases , 105 ) , and the fiber pile bonding group was randomly divided into LuxaCore group and RelyX Unicem group according to the outpatient treatment sequence number . The LuxaCore group ( 42 cases , 53 ) was broken into 1 / 3 fracture group ( 23 cases , 29 ) and RelyX Unicem group ( 42 cases , 52 ) were divided into 1 / 3 fracture group ( 20 cases , 23 ) and 1 / 3 fracture group ( 22 cases , 29 ) .
In another 67 cases ( 77 teeth ) were treated with fiber pile + resin restoration group by using fiber pile + resin restoration group as contrast reference . The direct bonding group used fiber pile + resin to repair the broken crown . After 6 months to more than 2 years , the self - made satisfaction evaluation scale was used to evaluate the degree of fullness and to conduct permanent repair .

Results :

The two components of LuxaCore group and RelyX Unicem group were 100 % in 1 year and 93.33 % higher than that in the direct bonding group ( Chi - square test , x2 = 7.53 , P0.05 ) . The success rate of LuxaCore group from 1 year to 2 years was 92.86 % , and the RelyX Unicem group was 92.68 % , which was higher than 73.91 % in the direct bonding group ( Chi - square test , x2 = 6.3803 , P0.05 ) . The success rate of LuxaCore group was 84.62 % in 2 years , and the RelyX Unicem group was 81 . 82 % , which was higher than 53.33 % in the direct bonding group . The difference was statistically significant ( chi - square test , x2 = 6.33 , P0.05 ) . In the fiber pile bonding group , the success rate of the 1 / 3 fracture group was higher than that of the 1 / 3 fracture group , but there was no significant difference between the two groups . In the fiber pile bonding group , 21 cases were permanently repaired without removal of the bonded fracture end , 1 case failed , the failure rate was 4.76 % , and the failure rate of the fiber pile + resin repair group was no difference .

The results of immediate repair satisfaction showed that the satisfaction score of fiber pile was 8.41 卤 1.41 , which was higher than 7.67 + 2.09 in the direct bonding group and 6.58 卤 1.37 in the fiber pile + resin repair group ( t test , P0.05 ) . Long - term satisfaction survey showed that the satisfaction score of fiber - pile bonding group was 6.15 卤 1.76 , which was higher than 4.58 卤 2.27 in the direct bonding group and 4.30 卤 1.35 in fiber pile + resin repair group ( t - test , P0.01 ) . The results showed that the original prosthesis was attractive and the function was good . The result showed that the ratio of fiber pile was the highest , which reached 72.97 % , which was higher than 55.81 % of the fiber pile + resin repair group .

In the analysis of the influencing factors of failure cases , the failure rate of normal occlusion cases in the direct bonding group was lower than that in the case of deep covering , and the difference was statistically significant ( chi - square test , x2 = 6.2382 , P0.05 ) . In the case of root development , the failure rate of tooth root in the fiber pile bonding group was higher than that in the completed case , and the difference was statistically significant ( Chi - square test , x2 = 6.0287 , P0.05 ) . In the case of traumatic tooth loosening , the failure rate of 鈪，

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