老年人重度楔状缺损尖牙不同修复方法的效果比较

The effect of different filling methods in canine teeth with severe wedge-shaped defects in the aged patients

目的:比较不同修复方法治疗重度楔状缺损尖牙的效果。方法:134例牙髓无法保留的重度楔状缺损的尖牙老年患者,按随机数表分为充填修复组39例、纤维桩加强组48例和桩冠修复组47例,完善的根管治疗后分别采用充填修复、纤维桩加强充填和桩冠修复。经3年随访,采用Kaplan-Meier法绘制生存曲线,采用log-rank检验分析比较3组患牙修复后3年的生存情况。结果:充填修复组继发牙折15例,纤维桩加强组7例,桩冠修复组10例。纤维桩加强组和桩冠修复组患牙3年生存率高于充填修复组,差异有统计学意义(χ2=9.061,P<0.05),纤维桩加强组和桩冠修复组二组之间差异无统计学意义(χ2=0.6789,P>0.05)。结论:应用纤维桩加强充填修复可有效地减少根管治疗后的重度楔状缺损尖牙继发性折断发生,无需再行冠修复,经济快捷,符合微创的理念。

Objective： To compare the clinical efficacy of different filling methods in the aged patients with severe wedgeshaped defects. Method： 134 cases of severe wedge-shaped defect teeth in elde rly patients, according to the random number table is divided into three filling group. After perfect root canal therapy, 39 of them were treated by general filling method, 48 of them were treated by strengthened filling method with fiber post and 47 of them were treated by post-crown restoration. The effects of the different methods were compared in 3-year follow-up, which was analyzed by Kaplan-Meier survival curve and log-rank test. Results： 15 fractures were recorded in general filling group, 7 cases in strengthened filling group and 10 cases in post-crown restoration group. In 3-year follow-up, survival rate of strengthened filling group and post-crown restoration group were significantly higher than general filling group（log-rank test, χ2=9.061, P 〈0.05）. The survival rate between strengthened filling group and post-crown restoration group has no significant difference（χ2=0.6789, P 〉0.05）.Conclusion： The strengthened filling method can reduce secondary fracture occur in canine teeth with the severe wedge-shaped defects after root canal therapy, and do not need to crown restoration. This method is economical, quick, and consistent with the concept of minimally invasive.