不同纤维桩修复方式影响重度楔状缺损前磨牙的抗折性能

Fracture resistance ability of severe wedge-shaped premolar defects restored with fiber reinforced composite post by different methods

背景:以往的观点认为桩可以增强根管治疗牙的抗折裂强度,但近年来这种观念已引起争议,许多学者认为,根管的预备削弱了牙根,桩进一步增加了折裂的危险。目的:评价侧向加载条件下,采用不同纤维桩修复方法对重度楔状缺损前磨牙抗折性能的影响。方法:将50颗正畸拔除的人上颌前磨牙随机分为5组,每组10颗。A组为正常前磨牙;B-E组40颗牙均制备深达颊舌径1/3深度的重度楔状缺损,B组不做任何处理;C组经根管治疗,保留楔状缺损上方颊侧悬突牙体组织,颊、舌根管内采用LuxaPost高强度玻璃纤维桩、LuxaCore双固化冠核复合树脂修复缺损牙体组织;D组经根管治疗,保留楔状缺损上方颊侧悬突牙体组织,颊、舌根管内采用LuxaPost高强度玻璃纤维桩、LuxaCore双固化冠核复合树脂及金属全冠修复缺损牙体组织;E组经根管治疗,去除楔状缺损上方颊侧悬突牙体组织,颊、舌根管内采用LuxaPost高强度玻璃纤维桩、LuxaCore双固化冠核复合树脂及金属全冠修复缺损牙体组织。检测各组样本折裂强度。结果与结论:A-E组抗折载荷分别为(1 002.69±147.62),(439.28±66.34),(958.30±101.23),(1 207.09±143.48),(1 056.44±139.30)N。D组抗折载荷最高(P<0.01),B组最低(P<0.01),A、C、E三组间抗折载荷比较差异无显著性意义。表明纤维桩能增强重度楔状缺损牙的抗折能力,并且保留牙体组织有助于提高修复体的抗折性。

BACKGROUND：Previous studies show that the fracture resistant force of endodonticaly treated teeth can be improved by post. But this idea has been controversial in recent years. Many scholars believe that the root canal preparation might weaken dental root the post increases the risk of tooth fracture. OBJECTIVE： To evaluate the fracture resistance ability of severe wedge-shaped-defect premolar to oblique loading, which was restored with fiber reinforced composite posts by different therapy methods. METHODS：A total of 50 human maxilary premolars were randomly divided into five groups, with ten teeth in each group. They were given folowing treatments： Group A： 10 untreated premolars; Rest 40 premolars of Groups B, C, D and E were prepared 1/3 bucco-lingual distance for artificial severe wedge-shaped defects at the buccal cervix. Group B： untreated severe wedge-shaped defects premolars; Group C： severe wedge-shaped defects premolars were endodonticaly treated, remaining dentin over hang above the wedge shaped defect, LuxaPost posts reinforced in buccal canal and lingual canal, LuxaCore composite resin restored dentin defect; Group D： severe wedge-shaped defects premolars were endodonticaly treated, LuxaPost posts reinforced in buccal canal and lingual canal, LuxaCore composite resin restored dentin defect, and then covered with ful metal crown; Group E： severe wedge-shaped defects premolars were endodonticaly treated, removing dentin overhang above the wedge shaped defect, LuxaPost posts reinforced in buccal canal and lingual canal, restored with LuxaCore composite resin, and then covered with ful metal crown. Fracture resistance of each specimen was measured in each group. RESULTS AND CONCLUSION： The fracture strength of each group were Group A （1 002.69±147.62） N, Group B （439.28±66.34） N, Group C （958.30±101.23） N, Group D （1 207.09±143.48） N, and Group E （1 056.44±139.30） N. Group D had the highest fracture strength （P 〈 0.01）, while Group B had the lowest fracture strength （P 〈 0.01）. There were no significant difference among the fracture strength of Group A, Group C and Group E. Our findings indicated that the fracture resistance of the severe wedge-shaped defected premolar can be improved by fiber reinforced composite post and dentin above wedge shaped defect remained.