树脂直接充填修复术联合Biosplint固位纤维对行根管治疗患者牙齿抗折性能的影响

Effects of direct resin filling repair combined with Biosplint retention fibers on the fracture resistance of teeth in patients with root canal therapy

目的采用自体实验和离体实验分析树脂直接充填修复术联合Biosplint固位纤维对行根管治疗牙齿抗折性能的影响。方法自体实验纳入184例行根管治疗患者,根据修复方式分为树脂组(光固化树脂分层充填修复)和联合组(树脂充填联合Biosplint固位纤维修复),比较2组临床疗效、牙周健康状况、术后疼痛情况以及牙齿折裂发生率。离体实验纳入同期因矫正而拔出的健康前磨牙80颗,随机均分为A组(不进行任何处理)、B组(行常规根管治疗后不予以修复治疗)、C组(进行树脂充填修复)和D组(采用树脂充填联合Biosplint固位纤维修复),分析4组牙齿抗折性能及可修复情况。结果自体实验中,治疗后树脂组、联合组临床有效率分别为94.57%和96.77%,折裂率分别为14.13%和1.61%;2组牙周袋探诊深度(PD)和附着丧失(AL)、牙龈出血指数(BI)显著升高(P<0.05),PI显著降低(P<0.05),2组菌斑指数(PI)差异有统计学意义(P>0.05);2组VAS评分随时间逐渐降低,不同时间点比较有显著差异(P<0.05);树脂组和联合组患者及家属满意率分别为89.87%和97.14%(P<0.05)。离体实验中,4组离体牙齿折裂载荷从高到低依次为A、D、C、B组,差异有统计学意义(P<0.05),B、C组显著低于A、D组(P<0.05),C组显著高于B组(P<0.05)。结论树脂直接充填修复术联合Biosplint固位纤维用于根管治疗患者可有效抑制细菌附着,减少口腔疾病发生,且能显著提升患牙抗折性能,减少因牙齿病变及根管治疗所致患牙折裂,临床疗效值得肯定。

Objective To analyze the effects of direct resin filling repair combined with Biosplint retention fibers on fracture resistance of teeth in patients with root canal therapy by autologous and in vitro experiments. Methods A total of 184 patients with root canal therapy by autologous experiment were divided into resin group （layered filling repair with light cured resin） and combined group （resin filling combined with Biosplint retention fibers repair）, and the clinical efficacy, periodontal health, postoperative pain and the incidence rate of fracture resistance of teeth were compared between the two groups. Eighty healthy premolars extracted for correction at the same period by in vitro experiment were randomly divided into group A （without any treatment）, group B （no repair after routine root canal therapy）, group C （resin filling repair） and group D （resin filling repair combined with Biosplint retention fibers）, and the teeth fracture resistance and repairable conditions were analyzed among the four groups. Results In the autologous experiment, the clinical effective rates after treatment were 94.57% and 96.77% respectively in the resin group and the combined group （ P 〉0.05）, and the fracture rates were 14.13% and 1.61% respectively （ P 〈0.05）. The levels of PD, AL and BI significantly increased in both groups （ P 〈0.05）, while the level of PI significantly decreased （ P 〈0.05）, and there was no significant difference in PI between the two groups （ P 〉 0.05）. The VAS score in both groups gradually decreased with time, and there were significant differences at different time points （ P 〈 0.05）, but there was no significant difference between the two groups at the same time point （ P 〉0.05）. The satisfactory degrees of patients and their families were 89.87% and 97.14% respectively in the resin group and the combined group （ P 〈 0.05）. In vitro experiment, the fracture loads of teeth in vitro among the four groups from the highest to the lowest were groups A, D, C and B, and there were significant differences among the four groups （ P 〈0.05）, and the index in group B and C was significantly lower than that in group A and D （ P 〈0.05）, and the index in group C was significantly higher than those in group B （ P 〈0.05）, and there was no significant difference between group A and D （ P 〈0.05）. Conclusion Direct resin filling repair combined with Biosplint retention fibersin patients with root canal therapy can effectively inhibit bacterial attachment, reduce the occurrence of oral diseases, significantly improve the fracture resistance of affected teeth, and reduce the tooth fracture caused by dental lesions and root canal therapy, and it has exact clinical efficacy.