树脂纳米陶瓷Lava Ultimate髓腔内固位冠修复老年脑卒中病人短冠磨牙的疗效观察

Efficacy of resin nanoceramic Lava Ultimate intrapulpal cemented crowns for restoring short crown molars in elderly stroke patients

目的探讨树脂纳米陶瓷Lava Ultimate髓腔内固位冠修复老年脑卒中病人短冠磨牙的疗效。方法收集研究2018年3月至2021年10月北京市大兴区医院老年脑卒中短冠磨牙病人124例,根据修复方案分为两组,采用紫荆氧化锆全瓷冠修复治疗的61例病人为对照组,采用树脂纳米陶瓷Lava Ultimate髓腔内固位冠修复治疗的63例为观察组。采用改良美国公共卫生机构(United States public health service,USPHS)标准比较两组修复后6、12个月修复效果、微渗漏分级、并发症发生率、修复前、修复后12个月口腔健康影响程度量表中文版(OHIP-14)评分及修复后12个月李克特量表(Likert scale)评分。结果修复效果:修复后12个月观察组边缘密合度、颜色匹配度、修复体折裂、牙体完整性、继发龋合格率分别为93.65%(59/63)、93.65%(59/63)、96.83%(61/63)、96.83%(61/63)、95.24%(60/63),均高于对照组[80.33%(49/61)、81.97%(50/61)、83.61%(51/61)、81.97%(50/61)、83.61%(51/61)](P<0.05);微渗漏分级:两组修复后6、12个月微渗漏分级比较,差异无统计学意义(P>0.05);并发症:观察组并发症发生率3.17%(2/63)低于对照组14.75%(9/61)(P<0.05);口腔健康相关生活质量:修复后12个月观察组OHIP-14量表功能限制、生理疼痛、心理不适、生理障碍、心理障碍、社交障碍评分分别为(1.89±0.57)分、(2.03±0.62)分、(0.92±0.30)分、(0.53±0.18)分、(0.42±0.10)分、(0.63±0.25)分,均低于对照组[(2.55±0.74)分、(2.73±0.88)分、(1.29±0.27)分、(0.74±0.26)分、(0.31±0.13)分、(0.89±0.20)分](P<0.05);修复效果满意度:修复后12个月观察组修复效果自我评估、并发症满意度、生活质量满意度评分依次为(4.62±0.39)分、(4.25±0.44)分、(4.57±0.40)分,均高于对照组[(4.12±0.35)分、(3.86±0.35)分、(4.03±0.46)分](P<0.05)。结论树脂纳米陶瓷Lava Ultimate髓腔内固位冠修复应用于老年脑卒中病人短冠磨牙,修复效果良好,有助于降低并发症发生率,提高口腔健康相关生活质量,改善修复效果满意度。

Objective To investigate the efficacy of resin nanoceramic Lava Ultimate intrapulpal cementation crowns for restoring short crown molars in elderly patients with stroke.Methods One hundred and twenty-four elderly stroke patients with short crown molars in Beijing Daxing District Hospital from March 2018 to October 2021 were collected and studied,and assigned into 2 groups according to the restoration protocol,61 patients treated with zirconia zirconia all-ceramic crowns as the control group and 63 patients treated with resin nanoceramic Lava Ultimate intrapulpal cementation crowns as the observation group.The United States Public Health Service(USPHS)criteria were used to compare the restorative outcomes,microleakage grading,complication rates,pre-prosthetic and 12-month post-prosthetic Oral Health Impact Scale Chinese version(OHIP-14)scores and 12-month post-prosthetic Likert scale scores between the two groups at 6 and 12 months.Results Restoration effect:after 12 months of repair,the marginal fit,color matching,restoration fracture,tooth integrity,and secondary caries pass rate in the observation group were 93.65%(59/63),93.65%(59/63),96.83%(61/63),96.83%(61/63),95.24%(60/63),respectively,which were higher than those in the control group[80.33%(49/61),81.97%(50/61),83.61%(51/61),81.97%(50/61),and 83.61%(51/61)](P<0.05).Microleakage classification:there was no statistically significant difference in the microleakage classification between the two groups at 6 and 12 months after repair(P>0.05).Complications:the complication rate of the observation group was 3.17%(2/63),which was lower than that in the control group[14.75%(9/61)](P<0.05).Oral health-related quality of life:12 months after restoration,the OHIP-14 scale scores for functional limitations,physiological pain,psychological discomfort,physiological disorders,psychological disorders,and social disorders in the observation group were(1.89±0.57)scores,(2.03±0.62)scores,(0.92±0.30)scores,(0.53±0.18)scores,(0.42±0.10)scores,and(0.63±0.25)scores,respectively,which were lower than those in the control group[(2.55±0.74)scores,(2.73±0.88)scores,(1.29±0.27)scores,(0.74±0.26)scores,(0.31±0.13)scores,and(0.89±0.20)scores](P<0.05).Satisfaction with repair effect:12 months after restoration,the self-evaluation of repair effect,satisfaction with complications,and satisfaction with quality of life scores of the observation group were(4.62±0.39)scores,(4.25±0.44)scores,and(4.57±0.40)scores,respectively,which were higher than those of the control group[(4.12±0.35)scores,(3.86±0.35)scores,and(4.03±0.46)scores](P<0.05).Conclusion Resin nanoceramic Lava Ultimate intrapulpal cemented crown restorations applied to short crown molars in elderly stroke patients are restoratively effective and help reduce complication rates,improve oral health-related quality of life,and improve satisfaction with restorative outcomes.