金属预成冠对乳磨牙大面积龋病儿童活髓保存后的修复效果评价

Evaluation of the Clinical Effect and Cosmetic Effect of Preformed Metal Crown of Deciduous Teeth after Vital Pulp Therapy in the Treatment of Children with High-risk Caries

目的:探究金属预成冠(Preformed metal crown,PMC)对乳磨牙大面积龋病儿童活髓保存后的修复效果。方法:选取笔者医院2017年1月-2018年1月收治的乳磨牙大面积龋病儿童208例,按随机数表法分为观察组和对照组,每组104例。观察组患儿采用活髓保存后PMC修复方案,对照组患儿采用传统复合树脂充填治疗方案。比较两组患儿修复成功率、修复失败原因,同时比较修复18个月后两组患儿家属VAS评分。结果:两组患儿治疗后12个月内复查,观察组患儿修复成功率均略高于对照组,但差异均无统计学意义(P>0.05);治疗18个月后,观察组患儿修复成功率(87.74%)显著高于对照组(71.25%),差异具有统计学意义(P<0.05);两组患儿修复失败原因主要是继发龋和充填体脱落、破裂,其中观察组患儿继发龋的发生率(3.77%)明显低于对照组(15.94%),组间比较差异有统计学意义(P<0.05);观察组患儿家属VAS评分为(7.42±1.46)分,对照组为(8.20±1.31)分,观察组较对照组低,但组间比较差异无统计学意义(P>0.05)。结论:PMC对乳磨牙大面积龋病儿童活髓保存后的修复效果显著,可有效恢复正常咬合关系,维持儿童正常咀嚼功能及颌面发育,有效弥补复合树脂充填体易脱落、破裂以及继发龋发生率较高等缺点,值得在临床中推广应用。

Objective To investigate the effect of Preformed Metal Crown (PMC) on the preservation of pulp in large rickets of children with deciduous teeth.Methods A total of 208 children with large rickets who were treated in our hospital from January 2017 to January 2018 were enrolled.The patients were divided into observation group and control group according to the random number table method,104 cases in each group.In the observation group,the PMC repair protocol was used after the preservation of the pulp,and the control group was treated with the traditional composite resin filling treatment.The success rate of repair and the cause of repair failure were compared between the two groups.as well as the VAS scores of the families of the two groups.Results The recovery rate of the children in the observation group was slightly higher than that in the control group within 12 months after treatment.The difference was not statistically significant (P>0.05).After 18 months of treatment,the observation group suffered from the observation group.The success rate of repair (87.74%) was significantly higher than that of the control group (71.25%),and the difference was statistically significant (P<0.05).The causes of repair failure in both groups were mainly secondary sputum and filling detachment and rupture.The incidence of secondary spasm in the observation group (3.77%) was significantly lower than that in the control group (15.94%).The difference between the two groups was statistically significant (P<0.05).The VAS score of the family members in the observation group was (7.42±1.46) points,and that of the control group was (8.20±1.31)points.The observation group was lower than the control group,but there was no statistical difference (P>0.05).Conclusion PMC can significantly restore the normal occlusal relationship of children with large rickets of deciduous teeth,and can effectively restore normal occlusion.It can effectively compensate the detachment,rupture and secondary sputum of composite resin fillings.Higher shortcomings are worthy of promotion and application in the clinic.