固定修复体致龈缘炎病因分析

Analysis of the etiology of gingivitis caused by fixed prostheses

固定修复体因其美观、舒适等优势被患者广泛接受,提高了患者的生活质量。虽然牙周因素通常不会直接影响固定修复体的使用寿命,但是修复体与牙周组织的和谐至关重要,修复后基牙的牙周健康是决定修复体成功率的重要因素。制作不当的固定修复体可能会损害口腔组织的健康或加剧已有的牙周疾病,导致龈缘炎、牙周炎和咬合创伤等。其中龈缘炎是固定修复体修复后较为常见的问题,是基牙牙周病变发作的早期表现,有证据表明固定修复体的存在会增加基牙牙周病变的风险,影响固定修复体的美观和成功率,应该引起足够的重视。本文分析和归纳了固定修复体致龈缘炎的病因,包括修复体边缘位置、修复体边缘适合性、医源性因素、患者因素等方面,这些原因可以发生在修复前、修复中和修复后,医生在临床上应尽量规避这些病因,根据患者的情况进行合理的设计及精心操作,协助患者选择适合的材料,同时开展好口腔卫生宣教,延长固定修复体的使用寿命。

Fixed prostheses are widely accepted by patients for their aesthetic and comfort advantages,which improve the quality of life of patients.Although periodontal factors do not usually directly affect the longevity of fixed prostheses,the harmony between the prosthesis and periodontal tissue is critical,and the periodontal health of the restored abutment teeth is an important factor in determining the success of the restoration.Improperly fabricated fixed prostheses may compromise the health of oral tissues or exacerbate existing periodontal disease,leading to gingivitis,periodontitis,and occlusal trauma.The presence of fixed prostheses has been reported to increase the risk of periodontal diseases and affect the aesthetics and success of themselves,and should be taken seriously.In this review,we analyze and summarize the etiology of gingivitis caused by fixed prostheses,including marginal position and adaption,medical factors,patient factors,etc.These causes can occur before,during and after restoration,and doctors should try to avoid these etiologies in the clinic,design reasonably and operate carefully according to the patient's condition,assist the patient in choosing suitable materials,and carry out good oral hygiene education to extend the service life of fixed prostheses.