对比树脂直接充填和铸瓷高嵌体修复后牙缺损的疗效

Comparing the curative effects of direct resin filling and cast porcelain onlays on repairing defect of posterior teeth

目的探究树脂直接充填和铸瓷高嵌体修复后牙缺损临床疗效的差异性。方法选取我院2018年2月—2019年2月收治的53例后牙缺损患者,依据随机数字表法分为2组,对照组26例(患牙34颗)予以树脂直接充填修复;观察组27例(36颗患牙)予以铸瓷高嵌体修复。对比两组患者修复时间、正中咬合情况以及随访12个月后的修复效果、修复成功率以及修复前后的龈沟出血指数、牙龈指数评分和主观满意度。结果观察组修复时间,在修复后即刻、3个月的早接触发生率明显高于对照组(P<0.05);2组在修复后6个月的早接触无明显差异(P>0.05);观察组患侧[牙合]力百分比在修复后即刻、3个月、6个月后偏高于对侧;对照组偏低于对侧,差异无统计学意义(P>0.05)。观察组修复12个月后,在邻接关系、边缘密合和修复体完整性方面的比例明显高于对照组(P<0.05);SBI评分(0.62±0.12)、GI评分(1.34±0.24)和主观满意度评分(44.87±4.76)明显优于对照组的SBI评分(0.75±0.11)、GI评分(1.48±0.26)和主观满意度评分(38.84±4.03)(P<0.05)。结论对于后牙缺损患者,铸瓷高嵌体具有较优的咬合力分布,较低的牙龈指数和龈沟出血指数,较高的修复效果、成功率和主观满意度,但在修复时间和早接触发生率方面要差于树脂直接充填修复。

Objective To explore the differences of clinical effects of direct resin filling and cast porcelain onlays on repairing defect of posterior teeth. Methods Fifty-three patients with defect of posterior teeth who were treated in our hospital from February 2018 to February 2019 were selected and randomly divided into two groups. The control group(n=26, 34 sick teeth) was given direct resin filling, and the observation group(n=27, 36 sick teeth) was given cast porcelain onlays repairing. The repair time, median occlusal condition, follow-up of repair effect after 12 months, success rate of repairing, gingival groove bleeding index, gingival index score and subjective satisfaction of patients before and after repairing were compared between the two groups. Results The repair time and premature contact incidence right after repair and 3 months after repair in the observation group were significantly higher than those of the control group(P<0.05). There was no significant difference in premature contact incidence at 6 months after repair between two groups(P>0.05). The percentage of occlusal force of affected side in the observation group right after repair and 3 and 6 months after repair was higher than that of the contralateral side, but the percentage of occlusal force in the control group was lower than the contralateral side, and the difference was not statistically significant(P>0.05). After 12 months of repair, the proportion of adjacency, edge tightness and completeness of the restoration in observation group were significantly higher than those in control group(P<0.05). The SBI score(0.62±0.12), GI score(1.34±0.24) and subjective satisfaction score(44.87±4.76) in observation group were significantly better than those in control group(SBI score(0.75±0.11), GI score(1.48±0.26) and subjective satisfaction score(38.84±4.03))(P<0.05). Conclusion For patients with defect of posterior teeth, cast porcelain onlays have better occlusal force distribution, lower gingival index and gingival groove bleeding index, better repair effect, higher success rate and subjective satisfaction, but the effect of cast porcelain onlays is not as good as direct resin filling in repair time and premature contact incidence.