Ceramage聚合瓷嵌体修复牙体缺损疗效观察

Ceramage polymerization porcelain inlay in the treatment of tooth defect:observation on one-year curative effect

目的对Cermage聚合瓷高嵌体和多面嵌体修复根管治疗后大面积缺损的磨牙与前磨牙临床疗效进行评价。方法选择2013年3—12月大连医科大学附属第一医院口腔科就诊的52例患者的54颗患牙,完善根管治疗后,按照嵌体预备原则行Ceramage聚合瓷高嵌体和多面嵌体修复,患者戴入修复体后即刻和1年后随访,参照美国公共健康协会(USPHS)的修正标准制定此次研究的嵌体评估标准。结果修复后即刻检查修复体固位、边缘密合性、牙龈邻接关系以及修复体颜色匹配程度等,44颗聚合瓷嵌体试戴后参照各项嵌体评估标准均达到A级,修复效果满意;10颗修复体颜色与牙齿稍有差异,颜色匹配程度达到B级,修复体颜色的匹配性达81.5%。修复后1年随访率94.2%,失访3例;1年后再次检查评估,51颗修复体表面视诊、探诊均光滑,未出现粗糙面,边缘密合度好,未出现继发龋、牙体折裂,修复效果达到A级;3例修复体边缘有轻微着色,修复效果达到B级;9例修复体与牙体颜色和透明性有差异但不明显,修复效果达到B级;3例修复体与邻牙出现轻微食物嵌塞,但牙线可清除,牙龈稍有红肿,修复效果达到B级;36例修复体各项评估标准满意程度与可接受程度均达到100%。结论Ceramage聚合瓷高嵌体和多面嵌体修复是用于后牙根管治疗后牙体缺损的一个优先考虑的选择。

Objective To evaluate the clinical effects of Ceramage polymerization ceramic onlay and polygon surface inlay in repairing large defects of the tooth after the premolar and molar root canal therapy. Methods Choose 54 teeth from 52 patients （32 females and 20 males）who were given root canal therapy in the Department of Stomatology of the First Affiliated Hospital of Dalian Medical University from March to December in 2013. Ceramage polymerization ceramic onlay and polygon surface inlay were used to repair and cement the inlay based on the principle of inlay preparation, and then these patients were followed up from right after the therapy to a whole year. The evaluation criteria shall be in accordance with the standard criteria of the USPHS （United States Public Health Service）depending on the evaluation re- sults. Results After checking the restoration retention, marginal adaptation, interproximal contact and color matching of the restoration, we learned that the repair level of 44 polymerization ceramic inlays have achieved level A after the try-in according to the evaluation criteria. The other 10 restorations achieved level B due to their small color difference with the normal teeth with a color matching degree of 81%. One year later, the follow-up rate was 94.2% with 3 failures. One year later, 51 restorations were smooth in marginal area and showed a great marginal adaptation; there were no sec-ondary caries or mobility between the restorations and teeth, a repairing effect of level A being achieved; 3 restorations had been colored slightly, with repairing effect reaching level B ; repairing effect of 9 restorations reached level B by showing a slight difference in colors. 3 restora-tions had slight food;the adjacent teeth which could be eliminated by floss and the gingiva showed a subtle swelling, with repairing effect reaching level B ; in 36 restorations the satisfactory and acceptable level of all evaluation criteria reached 100%. Conclusion Ceramage polymerization ceramic onlay and polygon surface inlay are feasible and practical in repairing large defects of the tooth after the molar root canal therapy.