不同桩核材质和牙本质肩领对前牙残根修复效果影响的临床研究

Effect of Ferrule Length on the Survival of Pulpless Residual Roots Restored with Two Different Post-and-core Materials:a Clinical Study

目的：比较研究不同桩核材质和牙本质肩领对前牙残冠残根桩核修复疗效的影响。方法：选取前牙残冠残根患者84例,共计98颗患牙,按照桩核材质不同分为两组,其中纤维桩核组（Gfp组）61例,铸造桩核组（Gcp组）37例。所有病例经桩核修复后,根据剩余牙体组织量在残根颈部制备一定高度的牙本质肩领（0~1mm、1~2mm、〉2mm）后,均给予常规烤瓷冠修复。随访观察2~5年,统计各组残根的治疗成功率并进行统计学分析。结果：Gfp组和Gcp组的治疗成功率分别为90.2%（55/61）和86.5%（32/37）,组间差异无统计学意义（P=0.58）。所有11例失败患牙中,牙本质肩领在0~1mm之间9例、1~2mm之间2例,肩领高度在2mm以上者无一失败,经χ2检验,牙本质肩领高度可以显著影响残根的预后疗效（P〈0.05）。结论：预成纤维桩和铸造桩均可用于前牙残冠残根的桩核修复;在残根颈部制备1mm以上高度的牙本质肩领,可以显著提高残冠残根的治疗成功率。

Objective：To evaluate the effect of post material and ferrule length on the survival of residual crown and roots restored with dowel and crowns.Methods：98defect teeth of residual crown and roots in 84patients were divided into 2groups.61teeth were restored with prefabricated fiber post-and-core system（named Group Gfp）and 37teeth restored with cast post-and-core system（named Group Gcp）.After dowel restoration,all teeth were prepared with different ferrule lengths and restored with ceramic crowns.The success rate of prostheses was observed after 2to 5years and the data was analyzed byχ2 test.Results：The success rates for Group Gfp and Gcp were 90.2%（55/61）and 86.5%（32/37）respectively,and there was no significant difference between two groups.Among 11failed teeth,9teeth were with the ferrule length 0to 1mm,2teeth in 1to 2mm,and no teeth was failed with the ferrule length more than 2mm.Ferrule length significantly affected the survival of residual roots（P〈0.05）.Conclusion：It is alternative to restore residual crown and roots with fiber post-and-core or cast dowel system,and more than 1mm ferrule length will significantly increase the success rate of pulpless residual roots.