聚醚醚酮在桩核修复中的应用进展

Application progress of polyetheretherketone in post and core restoration

牙冠大面积缺损的牙齿在根管治疗后常常要进行桩核修复。在传统桩核材料中,金属、陶瓷桩核由于高强度和高弹性模量,容易引发根折且难以取出;而预成纤维桩与根管的匹配性不佳,温度和水分的变化也可能导致其挠曲强度下降,引发粘接失败。相较于传统桩核材料,新型热塑性聚合物聚醚醚酮可数字化切削一体化成形,具有与牙本质相近的物理特性,优异的生物相容性以及良好的机械、粘接和美学性能。作为桩核修复材料时,可以获得理想的根管匹配性、牙根内均匀的应力分布以及与牙本质壁间良好的粘接效果,可能成为一种理想的替代材料。此外,通过加入并改变填料含量,相较于聚醚醚酮,其增强材料可能可以获得更好的机械、粘接和美学性能。然而,由于聚醚醚酮的表面能低且耐表面改性,透光性较差等特点,其美学性能和粘接性能有待提高,在美学区应用时需要进行一定的处理以获得理想的修复效果。目前,关于聚醚醚酮作为桩核材料的研究主要集中在体外试验,临床研究不多但均获得了满意的修复效果。为此本文从材料、相关性能、临床应用三个方面对聚醚醚酮桩核修复的进展进行评价,为今后其推广应用提供参考。

Teeth with a large area of crown defect often require post-core restoration after root canal treatment. Among the traditional post and core materials, metal and ceramic post-cores are prone to root fracture and difficult to be removed due to their high strength and elastic modulus. However, the prefabricated fiber post does not match well with the root canal,and changes in temperature and moisture may also occur, which leads to a decrease in its flexural strength and bonding failure. Compared with the traditional post and core materials, the new thermoplastic polymer polyetheretherketone(PEEK)can be digitally cut and integrally formed, and has similar physical properties to dentin, excellent biocompatibility, and good mechanical, adhesive and aesthetic properties. When used as a post-core restoration material, it can obtain ideal root canal matching, uniform stress distribution in the root and good bonding effect with the dentin wall, which may become an ideal substitute material. In addition, by adding and changing filler content, the reinforcement material may obtain better mechanical, adhesive and aesthetic properties than PEEK. However, due to the low surface energy, resistance to surface modification, and poor light transmittance of PEEK, its aesthetic properties and adhesive properties still need to be improved,and certain treatments are required to obtain an ideal restoration when applied in the aesthetic area. At present, the researches on PEEK as post and core material mainly focus on the in vitro study. There are few clinical studies, but satisfactory results have been achieved. Therefore, this review evaluates the progress of post and core restoration using PEEK from three aspects of material, properties and clinical application, so as to provide reference for its extensive application in the future.