全瓷嵌体修复儿童第一恒磨牙严重缺损的效果

Clinical observations of all-ceramic restorations of children's first permanent molars with severe defects

目的观察全瓷嵌体修复治疗儿童第一恒磨牙重度缺损的临床效果。方法已行完善牙髓治疗的第一恒磨牙严重牙体缺损患者34例,年龄7～15岁,共40颗患牙,使用CEREC系统进行全瓷修复,制备8颗全瓷嵌体和32颗高嵌体,使用复合树脂水门汀粘固。修复后即刻和24个月时对患者进行满意度调查,12个月和24个月使用改良美国公共卫生服务(United States Public Health Service,USPHS)标准评价临床疗效,评价项目包括继发龋、边缘适合性、外形、颜色匹配、破裂、解剖形态、邻接关系、牙龈健康状况。结果 40颗全瓷修复儿童第一恒磨牙,修复后24个月,修复体的继发龋、外形、破裂三项指标都100%达到A级,边缘适合性、颜色匹配、解剖形态、邻接关系和牙龈健康状况其他指标也85%以上达A级。24个月和12个月结果比较,各项指标差异均无统计学意义(P>0.05)。患者修复后即刻、修复后24个月的主观评价满意率均达94%以上。结论使用CEREC椅旁全瓷嵌体/高嵌体微创修复可以作为儿童恒磨牙严重牙体缺损的有效治疗方案,疗效确切,满意度高。

Objective To explore the therapeutic efficacy of chairside CEREC all-ceramic restorations in children with first permanent molars with severe defects and to summarize the clinical methods and procedures.Methods Forty teeth of 7-15 years old thirty-four children with first permanent molars with severe defects were selected.After careful tooth preparation,a total of 40 all-ceramic restorations(8 inlays,32 onlays)were designed and manufactured using the CEREC 3D system,and all prostheses were bonded with composite resin cement.Immediately after treatment and after 24 months,the subjective satisfaction of the patients was assessed.The clinical efficacy was analyzed using modified USPHS criteria at 12 months and 24 months.Evaluations included secondary caries,marginal adaptation,surface texture,color matching,fracture,anatomical form,adjacency relationship and gingival health.Results For the 40 all-ceramic restorations of the first permanent molars,after 24 months,100%of the teeth were grade A for secondary caries,surface texture and fracture of the prosthesis,and 85%of the teeth were up to grade A for the other indexes at 12 and 24 months.There were no significant differences(P>0.05)between 12 months and 24 months.Immediately after treatment and after 24 months,the subjective satisfaction of the patients was greater than 94%.Conclusion Application of the CEREC 3D system had a clear curative effect and resulted in high satisfaction in the repair of permanent molars with severe defects in children.