玻璃纤维桩核联合全瓷冠修复在前牙残根残冠患者中的应用观察

Application of glass fiber post-core combined with all-ceramic crown restoration in patients with residual crown of anterior teeth

目的观察玻璃纤维桩核联合全瓷冠修复在前牙残根残冠患者中的应用效果。方法 60例(72颗牙)前牙残根残冠患者根据治疗方案分对照组(给予铸造金属桩核+全瓷冠修复)和实验组(给予玻璃纤维桩核+全瓷冠修复),每组30例(36颗)。观察及对比两组治疗后12个月的残根残冠修复效果、咀嚼功能(咀嚼效率、咬合力)、炎症相关因子[前列腺素E2(PGE2)、基质金属蛋白酶2(MMP2)、细胞间黏附分子(CAM1)]水平及并发症发生情况。结果治疗后12个月,两组均无脱落病例,实验组的修复成功率高于对照组(93. 3%vs 73.3%,P<0.05);咀嚼效率、咬合力均较同组治疗前明显提高,且以实验组更为显著(P<0.01);两组龈沟液中PGE2、MMP2、CAM1水平均较同组治疗前降低,且以实验组更为显著(P<0.01)。两组并发症发生情况无明显差异。结论前牙残根残冠患者采用玻璃纤维桩核联合全瓷冠修复,在改善咀嚼功能、提高修复效果方面发挥重要作用,值得临床推广。

Objective To observe the effect of glass fiber post-core combined with all-ceramic crown restoration in the treatment of patients with residual crown of anterior teeth. Methods A total of 60 patients (72 teeth) with residual crown of anterior teeth admitted to our hospital were selected and randomly divided into the Control Group and the Experimental Group according to therapeutic regimen, 30 cases (36 teeth) in each group. The Control Group was repaired with cast metal post-core + all-ceramic crown while the Experimental Group was repaired with glass fiber post-core + all-ceramic crown. The two groups were observed and compared in terms of the restoration effect of residual root and crown repair at 12 months after the treatment, masticatory function (masticatory efficiency and occlusal force), the level of inflammation related factor [prostaglandin E2 (PGE2), matrix metalloproteinase 2 (MMP2) and intercellular adhesion molecule (CAM1)] and the incidence of complications. Results 12 months after the treatment, there were no cases with abscission in both groups, and the Experimental Group had the success rate of restoration higher than the Control Group (93.3% vs 73.3%, P<0.05). Both groups had the masticatory efficiency and occlusal force significantly improved compared with those before the treatment, and the Experimental Group had a more significant improvement (P<0.01). Both groups had the PGE2, MMP2 and CAM1 level in gingival crevicular fluid significantly decreased compared with those before the treatment, and the Experimental Group had a more significant decrease (P<0.01). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion The repair of residual crown of anterior teeth with glass fiber post-core and all-ceramic crown plays an important role in improving masticatory function and restorative effect. It is worth clinical promotion.