微型固位钉式无冠粘结固定义齿的临床应用研究

Clinical trial of resin-bonded fixed partial denture incorporating an attachment used to replace single anterior or premolar teeth

目的 :评价微型固位钉和金属翼板辅助固位的树脂粘结固定义齿修复单个中间缺失的前牙或前磨牙临床效果。方法 :对 2 1例单个上颌前牙或前磨牙中间缺失患者进行无冠粘结固定义齿 (crownlessbridgeworks ,CBW )系统修复 ,在修复后即刻、1个月及 2年后对修复体的固位、边缘密合性、美观、口腔卫生状况、牙体牙周健康等项目进行评价。同时 ,对 2 0例单个中间牙缺失患者采用传统的 3单位全冠固位固定义齿方法修复并给以同期评价。 2组患者各评价项目的满意率之间采用卡方检验进行统计学比较。结果 :2年后 ,2组固定桥修复均无脱落。所有临床评价项目均为满意或可接受 ,无继发龋发生。 2组之间各项目的Fisher精确校正或连续校正卡方检验没有统计学上的显著性差异 (P >0 .0 5 )。结论 :CBW树脂粘结固定修复法具有磨除牙体组织少、无需麻醉、对牙体牙周组织影响小、易于掌握等优点。在本研究所观察的时间限度内 ,可作为传统固定修复的替代方法来修复中间缺失的单个前牙或前磨牙 。

Objective:To evaluate the clinical performance of a new resin-bonded fixed partial denture (FPD) system, crownless bridge works (CBW).Methods:CBW was used to replace 12 single maxillary anterior and 9 premolar missing teeth in 20 subjects. Conventional 3-unit fixed partial denture (metal ceramic crowns or complete cast metal crowns, CFPD) was used to replace 10 single anterior and 10 single posterior missing teeth in 20 age-matched controls. Retention, marginal integrity, periodontal condition of the FPDs, esthetics and hygiene of pontics, and secondary caries of abutment teeth were clinically evaluated according to criteria right after, 1 month and 2 years after the cementation of each fixed partial denture. Between-group results were compared statistically using Fisher's exact test and/or continuity corrected Chi-square test. Results: In the 2-year observation no failure was found in the resin-bonded CBWs and conventional FPDs because of de-bonding from the abutment teeth. All the clinical results evaluated in both groups were satisfactory or acceptable. No secondary caries was found in both groups. Fisher's exact test and/or continuity corrected Chi-square test showed no significant differences of satisfactory rates between the two groups for all variables evaluated(P>0.05). Conclusion: The short-term clinical result indicates that resin-bonded CBW may be used as fixed prostheses to replace lost single anterior or premolar teeth with minimum preparation of abutment teeth. This restoration does not adversely influence the health of dental pulp and periodontal tissues.