后牙根管治疗后铸瓷高嵌体与钴铬金属烤瓷全冠修复短期疗效的比较研究

发布时间：2018-05-30 23:44

本文选题：高嵌体 + 全冠　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的本研究通过比较后牙根管治疗后铸瓷高嵌体修复与钴铬金属烤瓷全冠修复的短期疗效,评估根管治疗后行这两种不同的修复方式一年期间的4个方面的疗效,即:修复体外形完整性、牙周健康状况、食物嵌塞、修复体边缘密合度,以期为临床上后牙根管治疗后修复方式的选择提供理论依据。对象和方法收集2014年07月至2016年12月期间,就诊于天津武警后勤学院附属医院口腔科的120例因龋病引起牙髓炎而需要做根管治疗术的门诊患者。入组的120例患者,年龄为22-69岁,平均年龄为35.9岁;患牙120颗,其中磨牙68颗,前磨牙52颗;上颌牙58颗,下颌牙62颗。患牙行根管治疗后行牙周基础治疗,并在牙周基础治疗一周后行修复治疗,120例患者,按照随机数表随机分配为2组进行修复治疗,其中铸瓷高嵌体组60例,男32例,女28例;钴铬金属烤瓷全冠组60例,男34例,女26例。120例患者修复治疗后按照3个月、6个月、12个月进行随访,分别从修复体外形的完整性、牙周健康、食物嵌塞和修复体边缘密合度4个方面,评价对比这两种修复方式的短期临床治疗效果。4个方面的具体评价指标如下:(1)修复体外形的完整性方面分四级:A代表修复体完整性良好,B代表修复体外形有小的缺损,并不影响使用,C代表修复体有折断,D代表修复体脱落;(2)牙周健康状况方面分三级:A代表牙周健康无炎症,B代表轻度牙周炎症,C代表牙周炎症明显,探诊牙龈出血,可探及牙周袋;(3)食物嵌塞方面分二级:A代表与邻牙邻接关系良好,未见食物嵌塞,B代表与邻牙邻接关系较松,存在食物嵌塞;(4)修复体边缘密合度方面分三级:A代表边缘密合良好,不能用探针检测到间隙,B代表探诊探有间隙,但探针无法进入,C代表探诊有间隙,探针可进入。结果比较铸瓷高嵌体与钴铬金属烤瓷全冠,在修复体外形完整性、食物嵌塞、修复体边缘密合度这三项评价指标,均无统计学意义(P0.05);而牙周健康的评价指标具有统计学意义(P0.05)。在修复体外形完整性方面,12个月内随访修复体折断情况,铸瓷高嵌体组与钴铬金属烤瓷全冠组折断率均为5%。从修复体脱落率分析,铸瓷高嵌体组脱落率为7%,钴铬金属烤瓷全冠组脱落率为13%。随访12个月牙周健康情况分析,铸瓷高嵌体组的所有病例牙周组织均健康,达100%,而钴铬金属烤瓷全冠组牙周健康,无炎症的患者仅为82%。结论1.根管治疗后铸瓷高嵌体与钴铬金属烤瓷全冠从修复体完整性、食物嵌塞、边缘密合度这三方面短期疗效相同,在牙周健康方面铸瓷高嵌体明显优于钴铬金属烤瓷全冠。2.就修复体外形完整性中的脱落情况而言,钴铬金属烤瓷全冠比铸瓷高嵌体更容易脱落。
[Abstract]:Objective to compare the short term effects of post root canal restoration with cast porcelain high inlay and cobalt-chromium metal fused porcelain crowns, and to evaluate the effects of these two different restoration methods in one year after root canal therapy. That is, the integrity of the prosthesis, periodontal health, food impaction, and the tightness of the restoration edge, in order to provide a theoretical basis for the selection of repair methods after the treatment of the posterior root canal. Participants and methods from July 2014 to December 2016, 120 outpatients who needed root canal therapy for dental pulpitis caused by dental caries in the Department of Stomatology, affiliated Hospital of Tianjin Armed Police Logistics College were collected. 120 patients, aged 22-69 years, with an average age of 35.9 years, had 120 teeth, including 68 molars, 52 premolars, 58 maxillary teeth and 62 mandibular teeth. After root canal treatment, 120 patients were treated with restoration therapy after one week of periodontal basic treatment. According to the random number table, 120 patients were randomly divided into 2 groups, including 60 patients in the cast porcelain hyperinlay group, 32 males and 28 females, and the patients were divided into two groups: the group with cast porcelain hyperinlay (n = 60), the group of male (n = 32), and the group of female (n = 28). There were 60 cases (34 males, 26 females) in the cobalt-chromium porcelain full crown group. The patients were followed up for 3 months, 6 months and 12 months, respectively, from the integrity of the prosthesis appearance and periodontal health, according to 3 months, 6 months, 12 months, respectively. 4 aspects of food impaction and edge tightness of restoration, To evaluate the short-term clinical therapeutic effect compared with these two methods. The specific evaluation indexes of the four aspects are as follows: 1) the integrity of the prosthesis is divided into four levels: 4% A represents good restoration integrity and B represents small defect in the shape of the prosthesis. It does not affect the use of Con C as a representative of a broken restoration, D as a representative of a prosthesis, and 2) periodontal health. In terms of periodontal health, there are three levels: a representing periodontal health and B representing periodontal health; B representing mild periodontitis; C representing periodontitis obviously; probing gingival bleeding. In the case of food impaction, there was a good relationship between the second grade: a representative and the adjacent teeth, but no food impaction B representative had a looser relationship with the adjacent teeth. There is a food inlay (4) in the case of edge tightness of the prosthesis, the third grade: a means the edge is good, the gap B can not be detected by the probe, but the probe can not enter the probe, and the probe can enter. Results there was no significant difference among the three evaluation indexes, including the integrity of the prosthesis, the food impaction and the tightness of the restoration edge, but the evaluation index of periodontal health was significantly higher than that of the cobalt chromium fused porcelain crown and the cast porcelain high inlay (P 0.05), while the evaluation index of periodontal health was significantly higher than that of the control group (P 0.05). In the aspect of the integrity of the prosthesis, the fracture rate was 5% in the cast-porcelain high inlay group and the cobalt-chromium porcelain full crown group after 12 months follow-up. The exfoliation rate of cast porcelain high inlay group was 7 and that of cobalt-chromium full crown group was 13. The periodontal health of all the patients in the cast porcelain high inlay group was healthy and 100, while that in the cobalt-chromium porcelain full crown group was 82.The periodontal health of the patients without inflammation was only 82.The periodontal health was observed in the 12 months follow up and the results showed that the periodontal tissue of all the patients in the cast porcelain high inlay group was healthy and 100. Conclusion 1. After root canal therapy, the short-term curative effect of cast porcelain high inlay was the same as that of cobalt chromium metal fused porcelain crown from three aspects: integrity of restoration, food impaction and edge tightness. It was obviously superior to cobalt chromium metal porcelain crown. 2 in periodontal health, cast porcelain high inlay was superior to cobalt chromium metal porcelain crown. In terms of the exfoliation in the integrity of the prosthesis, the cobalt-chromium porcelain full crown is easier to fall off than the high-cast porcelain inlay.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.3

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