热压铸瓷嵌体、二氧化锆全瓷嵌体和氧化铝陶瓷嵌体修复牙邻颌面缺损的效果比较

Comparison of hot pressing cast porcelain inlay,zirconia all porcelain inlay and alumina ceramic inlay for repairing adjacent maxillofacial defects of teeth

目的比较牙邻颌面缺损患者应用热压铸瓷嵌体、二氧化锆全瓷嵌体、氧化铝陶瓷嵌体修复的临床效果。方法抽取新乡医学院第三附属医院2010年1月至2017年12月口腔科收治的牙邻颌面缺损患者120例(159颗牙),依据修复方案随机分组,其中采用热压铸瓷嵌体方案治疗50颗,二氧化锆全瓷嵌体方案治疗55颗,氧化铝陶瓷嵌体方案治疗54颗。开展平均12个月的随访,从修复体磨损、修复体颜色、基牙继发龋、边缘密合度、修复体形态方面,对疗效进行评定。结果12个月随访发现,三组在基牙继发龋、边缘密合度方面,总有效率均为100%,差异未见统计学意义(P>0.05)。但热压铸瓷嵌体组修复体颜色修复有效率为100%(50/50),高于二氧化锆全瓷嵌体组(74.55%,41/55)及氧化铝陶瓷嵌体组(83.33%,45/54),差异有统计学意义(P<0.05);在修复体形态方面,二氧化锆全瓷嵌体组为100%(55/55),高于热压铸瓷嵌体组(94.00%,47/50)及氧化铝陶瓷嵌体组(94.44%,51/54),但差异未见统计学意义(P>0.05);修复体磨损方面,二氧化锆全瓷嵌体组为100%(55/55),高于热压铸瓷嵌体组(78.00%,39/50)及氧化铝陶瓷嵌体组(83.33%,45/54),差异有统计学意义(P<0.05)。结论针对口腔科收治的牙邻颌面缺损患者,采用热压铸瓷嵌体方案、二氧化锆全瓷嵌体方案、氧化铝陶瓷嵌体方案修复治疗,在边缘密合度、基牙继发龋方面效果均较显著;但热压铸瓷嵌体方案在修复体颜色方面更为理想,二氧化锆全瓷嵌体方案在修复体形态、修复体磨损方面效果更为理想。临床可依据患者具体病情特征,对不同的全瓷材料做出个性化选择。

Objective To compare the effects of the application of hot pressing cast porcelain inlay, zirconia all porcelain inlay and alumina ceramic inlay for repairing adjacent maxillofacial defects of teeth.Methods A total of 120 cases (159 teeth) of the patients with adjacent maxillofacial defects of teeth treated in the Department of Stomatology of the Third Affiliated Hospital of Xinxiang Medical College from January 2010 to December 2017 were selected. According to the random groups of the repair scheme, 50 teeth were treated with hot pressed ceramic inlay, and 55 teeth were treated with zirconia all ceramic inlay, 54 teeth were treated with alumina ceramic inlay. The mean follow-up period was 12 months, and the curative effect was evaluated from the aspects of the wear of the prosthesis, the color of the prosthesis, the secondary caries of the abutment teeth, the marginal density and the shape of the prosthesis.Results The average follow-up period was 12 months. The total effective rate of secondary caries and marginal tightness of the three groups was 100%, and there was no significant difference between the three groups (P>0.05). However, the color repair effective rate of hot-pressed porcelain inlay group was 100% (50/50), which was significantly higher than that of zirconia all ceramic inlay group (74.55%, 41/55) and alumina ceramic inlay group (83.33%, 45/54), the difference was statistically significant (P<0.05), and the morphology of repaired porcelain inlay group was significantly higher than that of zirconia all ceramic inlay group (P<0.05). The percentage of zirconium all ceramic inlay group was 100% (55/55), which was higher than that of hot pressed porcelain inlay group (94.00%, 47/50) and alumina ceramic inlay group (94.44%, 51/54), but there was no significant difference (P>0.05). In terms of repair wear, the wear of zirconia all ceramic inlay group was 100% (55/55), which was significantly higher than that of hot pressed porcelain inlay group[78.00% (39/50)]and alumina ceramic inlay group [83.33% (45/54, P<0.05].Conclusions In view of the patients with adjacent maxillofacial defects of teeth in the stomatology department, the hot pressed ceramic inlay scheme, zirconia all ceramic inlay scheme and alumina ceramic inlay scheme were used to repair the defects. The results were significant in marginal cohesion and secondary caries of abutment teeth;however, the hot pressed ceramic inlay scheme is more ideal in the aspect of restoration color, and the zirconia all ceramic inlay scheme is more ideal in the aspect of restoration shape and restoration wear. According to the specific disease characteristics of patients, we can make personalized choice for different all ceramic materials.