乳磨牙根管治疗后4种不同修复方式疗效的比较

Comparison of four different restorative methods for deciduous molars after root canal therapy

目的:比较4种不同修复方式对根管治疗后(RCT)乳磨牙不同时期的临床疗效。探讨不同修复方式对儿童乳牙牙体缺损修复的治疗效果和安全性。方法:收集2018年12月—2020年3月于天津市口腔医院儿童口腔科就诊的183例患儿共计453颗因龋病继发牙髓炎或者根尖炎而需要做RCT术的乳磨牙。随机分为4组进行修复治疗,即:玻璃离子充填组、光固化树脂充填组、钴铬合金高嵌体组、金属预成冠(PMC)组。患牙修复治疗后进行为期2年的随访,比较4种修复方式不同时间段的治疗效果和不良反应。结果:3个月和6个月时随访结果显示4种修复方式的总体成功率比较无统计学意义(P>0.05)。1年和2年4种修复方式总体成功率有显著统计学差异(P<0.05)。结论:修复后3个月和6个月,乳磨牙RCT后玻璃离子充填组、光固化树脂充填组、钴铬合金高嵌体组、金属预成冠组4种不同修复方式疗效相近。修复后1年和2年,乳磨牙嵌体、乳磨牙金属预成冠修复方式优于光固化树脂和玻璃离子修复方式,其中乳磨牙金属预成冠修复方式最佳。

Objective:To compare the clinical effects of four different restoration methods on deciduous molars after root canal therapy(RCT)in different periods.To explore the therapeutic effect and safety of different restoration methods for children′s deciduous teeth defects.Methods:From December 2018 to March 2020,a total of 453 deciduous molars requiring RCT due to caries secondary pulpitis or apicitis were collected from 183 children in the Department of Pediatric Dentistry of Tianjin Stomatological Hospital.They were randomly divided into four groups for restorative treatment,namely,glass ionomer filling group,compound resin filling group,cobalt-chromium alloy onlay group and preformed metal crown(PMC)group.A 2-year follow-up was conducted after the restoration of the affected teeth,and the therapeutic effects and adverse reactions of the four restoration methods in different time periods were compared.Results:There was no significant difference in overall success rate among the four groups follow-up at 3 and 6 months(P>0.05).The comparison success rates of the four groups inone year and two years have significant statistical differences(P<0.05).Conclusion:Three and six months after restoration,four different restoration methods of primary molars after RCT,including glass ionomer filling group,compound resin filling group,cobalt-chromium alloy onlay group and metal pre-crown group,have similar curative effects.One and two years after restoration,the restoration methods of onlay and metal premolars of primary molars are better than those of compound resin and glass ionomer,among which preformed metal crown is the best.