纯钛和钴铬合金铸造基托在口腔修复中的应用

Comparison of pure titanium base denture with cobalt-chromium alloy base denture in dental prosthodontics

目的比较纯钛铸造基托和钴铬合金铸造基托在口腔修复中的临床疗效，探讨纯钛铸造基托义齿的临床应用价值。方法采用纯钛及钴铬合金铸造基托分别修复上颌肯氏Ⅰ类或Ⅱ类缺失患者各32例（纯钛组及钴铬合金组），检测并比较两组患者备牙前及戴牙后1、3个月义齿承托区黏膜面可培养细菌总量、可培养细菌分布情况以及义齿承托区黏膜的炎症情况。结果（1）钴铬合金组戴牙后3个月义齿承托区可培养细菌总量均显著多于备牙前及戴牙后1个月（均P〈0.01），而且戴牙后3个月钴铬合金组义齿承托区可培养细菌总量显著对于纯钛组（P〈0.01）。（2）纯钛组戴牙后3个月及钴铬合金组戴牙后1个月和3个月，黏膜链球菌、乳酸杆菌、放线菌及白色念珠菌均较备牙前显著增多（均P〈0.01），奈瑟菌显著减少（P〈0.01）；在戴牙后1个月和3个月两个时点，纯钛组链球菌、放线菌、乳酸杆菌、白色念珠菌、奈瑟菌均较钴铬合金组显著减少（均P〈0.01）。（3）钴铬合金组戴牙后1个月发生黏膜义齿性口炎2例（＋），戴牙后3个月发生6例（＋）、2例（＋＋）；而纯钛组仅戴牙后3个月2例发生黏膜义齿性口炎（＋），两组患者黏膜义齿性口炎发生率差异显著（P〈0.01），尤其在戴牙后3个月钻铬合金组较严重黏膜义齿性口炎的发生率显著高于纯钛组（P〈0.01）。结论纯钛具有良好的机械性能和生物学性能，不会影响口腔微生物的的生长及定植，可以防止微生态失调导致新的并发症出现，是一种较为理想的口腔缺损金属修复体。

Objective TO compare pure titanium base denture with cobalt-chromium （Co-Cr） alloy base denture in dental prosthodontics. Methods Sixty four patients who were ready to accept removable partial dentures were included in the study and divided into two groups. Thirty-two patients received pure titanium base denture while other thirty-two patients received co-cr alloy base denture. The total cultivable florae were counted before dentures were inserted, one month and three months after wearing, and the proportions of bacteria detected on the denture bearing areas were calculated, and the denture stomatitis was also investigated. Results Co-cr alloy base denture enhanced the accumulation of microflora on stress-bearing areas three months after wearing （P〈0.001）, however, not for pure titanium base denture after wearing （P〉0.05）. The increment of Lactobacilli, Candida albican, Actiomyce was higher in Co-Cr alloy base than that in pure titanium base denture and it was contrary to Neisseria （P〈0.001）.The incidence of denture stomatitis in pure titanium base denture was lower than that in Co-Cr alloy base denture （P〈0.05）. Conclusion Pure titanium base denture can restrain bacteria adhesion and is good for oral hygiene.