2种材料嵌体用于后牙Ⅱ类洞修复的临床效果比较

Comparison of clinical efficacy of CAD/CAM all-ceramic inlay and polymerid porcelain inlay in restoration of posterior Class Ⅱ cavity

目的 :比较CAD/CAM全瓷嵌体与Ceramage聚合瓷嵌体修复活髓后牙Ⅱ类洞的临床效果。方法 :选取牙体缺损活髓后牙需制备Ⅱ类洞的患者97例,共100颗患牙。随机分为2组,分别制作CAD/CAM全瓷嵌体与Ceramage聚合瓷嵌体修复。比较2组修复后12个月、24个月的效果,参照改良美国公共卫生服务评价体系(USPHS),评价术后牙敏感、修复体折裂、修复体脱落、边缘着色情况。采用SPSS13.0软件包对2种材料嵌体修复12个月、24个月的计数资料进行χ~2检验,等级资料进行Wilcoxon秩和检验。结果:12个月时,2组病例均修改成功,结果无显著差异(P>0.05)。24个月时,术后牙敏感、修复体脱落例数,2组比较无显著差异(P>0.05);修复体折裂发生例数,聚合瓷组低于全瓷组(P<0.05);边缘着色发生例数,聚合瓷组高于全瓷组(P<0.05)。结论:聚合瓷嵌体修复活髓后牙Ⅱ类洞术后抗折裂力高于CAD/CAM全瓷嵌体,缺点是边缘着色发生率较高,应根据患者的需求选择合适的修复方案。

PURPOSE： To compare the clinical efficacy of CAD/CAM all-ceramic inlay and polymerid porcelain inlay in restoring Class Ⅱ cavity of posterior teeth. METHODS： Ninety-seven patients with 100 posterior teeth of Class Ⅱ cavity were recruited in this randomized control trial; Among them, 50 patients were grouped into CAD/CAM all-ceramic inlays and 47 patients were grouped into Ceramage polymerid porcelain inlay. According to the modified USPHS criteria, the incidence of postoperative sensitivity, prosthesis fracture, prosthesis falling off, and edge coloration were evaluated 12 months and 24 months after restoration. χ~2 test and Wilcoxon rank sum test were used for statistical analysis using SPSS13.0 software package. RESULTS： Restoration in the 2 groups were successful, there was no significant difference at 12 months（P〉0.05）. Postoperative sensitivity and the incidence of prosthesis falling off in both groups were not significantly different（P〉0.05）; however, the number of prosthesis fracture of the polymerid porcelain was lower than that of the CAD/CAM all-ceramic inlays（P〈0.05）. The incidence of edge coloration of CAD/CAM all-ceramic inlays was lower than that of the polymerid porcelain at 24-month follow-up（P〈0.05）. CONCLUSIONS： Restoration with polymerid porcelain is more likely to have a higher success rate than those with CAD/CAM all-ceramic inlays. Patients undergoing CAD/CAM all-ceramic inlays have a lower incidence of edge coloration, compared with those undergoing polymerid porcelain.