计算机辅助设计与制作的聚合物渗透陶瓷桩核与金属桩核在牙体缺损修复中的比较

Clinical application of polymer-infiltrated ceramic post and core by computer-aided design and manufacture

目的探索计算机辅助设计与制作(computer aided design and computer aided manufacture,CAD/CAM)聚合物渗透陶瓷桩核与金属桩核在牙体缺损修复中的临床效果比较研究。方法选取32例患者,42颗牙体缺损的患牙接受CAD/CAM聚合物渗透陶瓷桩核或金属桩核及全瓷冠的修复。临床分为2组,A组(实验组):牙体缺损患牙22颗使用计算机辅助设计与制作(CAD/CAM)聚合物渗透陶瓷桩核、全瓷冠修复,B组(对照组):牙体缺损患牙20颗使用金属桩核、全瓷冠修复。修复后,以桩核的稳定性、有无桩核脱落、牙体组织折裂和桩核的折断作为观察指标,采用美国公共健康协会(United States Public Health Service,USPHS)的修订标准,检查修复体的外形、牙龈状况、表面质地、修复体的颜色匹配性、边缘适合性、修复体松动度以及患者满意度。结果32例患者,平均随访周期约(24.0±5.8)月。在随访期间,两组均未发现有桩核的脱落、折断和牙体组织的折裂,修复体完整。两组进行统计学Wilcoxon秩和检验,P>0.05,A、B两组修复效果在外形、牙龈状况、表面质地、边缘适合性、修复体松动度方面差异无统计学意义。修复体的颜色匹配性、患者满意度A组优于B组。结论CAD/CAM聚合物渗透陶瓷桩核修复牙体缺损临床效果良好,并且能够节省就诊时间,可作为代替传统金属桩核用于牙体缺损患牙的桩核冠修复的临床选择。

Objective Discuss the comparison of computer-aided design and manufacturing(CAD/CAM)polymer-infiltrated ceramic post and metal post and core in dental defect restoration.Methods In 32 patients,42 teeth with tooth defects were repaired by CAD/CAM polymer-infiltrated ceramic post cores or metal post cores and all-ceramic crowns.The clinic is divided into 2 groups.Group A(experimental group):22 teeth with dental defects are repaired with computer-aided design and fabrication(CAD/CAM)polymer infiltrated ceramic post cores and all-ceramic crowns.Group B(control group):Twenty teeth with tooth defects were repaired with metal post cores and all-ceramic crowns.Clinical observations were made on the stability of the post and core,whether the post and core fell off,the fracture of the tooth tissue and the fracture of the post and core after the restoration.The revised standards of the United States Public Health Service(USPHS)were used to observe shape,gingival condition,surface texture,color matching of the restoration,the edge suitability,looseness of the restoration and patient satisfaction of the restoration.Results For 32 patients,the average follow-up period was about(24.0±5.8)months.During the follow-up period,the two groups did not find any post-core fall off,fracture,or tooth tissue fracture,and the restoration was intact.The two groups were tested by Wilcoxon rank sum test,P>0.05.There was no statistically significant difference between the two groups A and B in terms of shape,gingival condition,surface texture,edge fitness,and looseness of the restoration.The color matching and patient satisfaction of the restorations are better in group A than group B.Conclusion CAD/CAM polymer-infiltrated ceramic post and core restorations have good clinical effects and save time for treatment.It can be used as a better clinical choice for the restoration of dental defects with post-core crowns.