不同材质冠修复体在后牙牙体缺损美学修复治疗中的疗效评价

Clinical Application Effect of Different Crown Restorations in the Aesthetic Repair Treatment of Posterior Tooth Defects

目的:探讨不同材质冠修复体在后牙牙体缺损美学修复治疗中的临床效果。方法:选取2018年9月-2020年3月于邯郸市中心医院就诊的86例下颌第二磨牙远中缺损患者为研究对象,采用随机数字表法将86例入组患者分为二氧化锆组(n=43)和钴铬合金组(n=43)。钴铬合金组采用采用钴铬合金烤瓷冠修复,二氧化锆组采用二氧化锆全瓷冠修复。比较两组患者随访1年后的后牙牙体缺损修复效果,修复前和修复后1个月龈沟液中的碱性磷酸酶(ALP)、基质金属蛋白酶-8(MMP-8)、肿瘤坏死因子-α(TNF-α)水平,修复前和修复后6个月的牙动度参数(PTV)、牙龈指数(GI)和菌斑指数(PLI),并比较两组不良反应发生率。结果:修复后1个月,二氧化锆组ALP、MMP-8、TNF-α水平均低于钴铬合金组(P<0.05);修复后6个月,二氧化锆组PTV、PLI和GI均低于钴铬合金组(P<0.05);修复后1年,二氧化锆组在边缘密合性、颜色匹配性和牙龈健康状况方面的修复成功率均高于钴铬合金组;且二氧化锆组患者不良反应发生率(4.65%)明显低于钴铬合金组(20.93%),差异均有统计学意义(P<0.05)。结论:相比于钴铬合金烤瓷冠修复,二氧化锆全瓷冠修复应用于后牙牙体缺损患者美学修复治疗中,可改善牙周组织状况和炎症状态,且边缘密合性、颜色匹配性、牙龈健康状况和安全性更好,具有较好的后牙牙体缺损修复效果。

Objective To explore the clinical application effect of different crown restorations in the aesthetic repair treatment of posterior tooth defects.Methods Eighty-six patients with distal defects of mandibular second molars treated in Handan Central Hospital were enrolled as the research objects between September 2018 and March 2020.According to random number table method,they were divided into zirconium dioxide group(n=43),zirconium dioxide all-ceramic crown for repair)and cobalt-chromium alloy group(n=43),cobalt-chromium alloy porcelain crown for repair).The repair effect of posterior tooth defects after 1-year follow-up,levels of alkaline phosphatase(ALP),matrix metalloproteinase-8(MMP-8)and tumor necrosis factor-α(TNF-α)in gingival crevicular fluid before and at 1 month after repair,tooth movement value(PTV),gingival index(GI)and plaque index(PLI)before and at 6 months after repair,and the incidence of adverse reactions between the two groups were compared.Results At 1 month after repair,levels of ALP,MMP-8 and TNF-α in zirconium dioxide group were lower than those in cobalt-chromium alloy group(P<0.05).At 6 months after repair,PTV,PLI and GI in zirconium dioxide group were all lower than those in cobalt-chromium alloy group(P<0.05).At 1 year after repair,success rates of repair in zirconium dioxide group were higher than those in cobalt-chromium alloy group in terms of edge sealing,color matching and gingival health(P<0.05).The incidence of adverse reactions in zirconium dioxide group was significantly lower than that in cobalt-chromium alloy group(4.65%vs 20.93%)(P<0.05).Conclusion Compared with cobalt-chromium alloy porcelain crown repair,the application of zirconium dioxide all-ceramic crown repair in the aesthetic repair treatment for patients with posterior tooth defects can improve periodontal tissues and inflammation status,and edge sealing,color matching,gingival health status and safety are better,with better repair effect of posterior tooth defects.