三种材料的高嵌体修复大面积后牙缺损的效果评价

Clinical effect of massive defect of the posterior teeth restored with three material onlays

目的:比较三种材料的高嵌体修复大面积缺损后牙的效果。方法:选取行根管治疗后的76名患者的100颗后牙,分别用IPS e.max.CAD瓷块、复合树脂、金合金进行高嵌体修复,在修复后1年、2年、3年后短期随防,根据改良后的USPHS标准评价其修复效果。结果:三组不同材料高嵌体在继发龋、边缘染色、牙周反应的差异无统计学差异。而金合金和瓷嵌体的完整性好于树脂嵌体,树脂嵌体对对颌牙的磨损程度低于瓷嵌体与金合金嵌体。结论:三种材质的高嵌体用于修复大面积缺损的后牙时,均能够减少牙周反应和防止继发龋的发生。其中瓷嵌体和金合金嵌体在边缘密闭性、邻接关系及修复体完整性方面,优于树脂嵌体,而瓷嵌体的美观性明显优于金合金嵌体,可满足临床美学修复的要求,但其强度高,易磨耗对颌牙。

Objective：To compare the therapeutic effect of three different material onlays on the restoration of the massive defect of the posterior teeth.Method：Seventy-six patients were treated with 100 onlays for the restoration of massive defect of the posterior teeth.Primary root canal treatment was performed and onlays were fabricated with IPS e.max.CAD ceramics,composite resin and gold alloy alternatively.All restorations were evaluated at one year,two years,three years after placement.The clinical effects of three groups were compared according to the modified USPHS.Result：The three groups had no difference in marginal adaption,interproximal relations,periodontal reaction as well as marginal discoloration.In restoration integrity and the abrasion of opposite teeth,composite resin onlays and gold alloy onlays were better than IPS e.max.CAD ceramic onlays while composite resin onlays and IPS e.max.CAD ceramic onlays are obviously better than gold alloy onlays in color match.Conclusion：Good marginal adaptation as well as interproximal relations could be reached by the three different material onlays on the restoration of the masssive defect of the posterior teeth,which decreased the occurrence of periodontal disease and secondary caries.Thanking to their excellent fracture resistance and good apperance,onlay restorations fabricated with composite resin can be a good option for the restoration of the massive defect of the posterior teeth.However,the long-term reaction of resoration was left to be studied in the future.