前磨牙穿髓形楔状缺损修复方式的临床效果观察

Observation on clinical effect of different repair methods on wedge-shaped defects with penetrating pulp in premolars

目的比较两种修复方式对不同缺损类型的露髓型楔状缺损的修复效果的影响。方法选择河北医科大学口腔医院修复科就诊的80例已行根管治疗后的露髓型楔状缺损的下颌前磨牙患者作为观察对象。根据楔状缺损的宽度及修复方式,分为A1组楔状缺损宽度在近远中径1/3以内:树脂充填+冠修复,A2组楔状缺损宽度在近远中径1/3以内:纤维桩核+树脂充填+冠修复,B1组楔状缺损宽度大于1/3小于邻颊轴角:树脂充填+冠修复,B2组楔状缺损宽度大于1/3小于邻颊轴角:纤维桩核+树脂充填+冠修复。分别比较4组治疗修复成功率以及修复后的效果。结果修复后2年复查,A1组与A2组修复成功率及修复效果比较差异无统计学意义(P>0.05)。B2组的修复成功率及修复效果高于B1组,差异有统计学意义(P<0.05)。结论楔状缺损宽度在1/3以内时,直接树脂充填即可达到良好的修复效果,而当楔状缺损宽度超过1/3而未超过邻颊轴角时,增加纤维桩可以提高修复成功率。

Objective To compare the effects of different repair methods on different types of wedge-shaped defects with exposed pulp.Methods Eighty patients receiving repair for different types of wedge-shaped defect with exposed pulp in mandibular premolars after root canal treatment in Department of Prosthodontics,School of Stomatology,Hebei Medical University,were selected.They were divided into group A1(wedge-shaped defect within 1/3 in width,and treated with resin filling+crown restoration,n=20),group A2(edge-shaped defect within 1/3 in width:fiber post-and-core+resin filling+crown restoration,n=20),group B1(wedge-shaped defect more than 1/3 and less than the axial angle in width:resin filling+crown restoration,n=20)and group B2(wedge-shaped defect more than 1/3 and less than the axial angle in width:fiber post-and-core+resin filling+crown restoration,n=20)based on the width of wedge-shaped defects and repair method.The success rate of repair treatment and the repair effect were compared in the four groups.Results At 2-year reexamination after repair,there was no significant difference in the success rate of repair treatment and repair effect between group A1 and group A2(P>0.05).The success rate of repair treatment and repair effect in group B2 was higher or better than those in group B1,and the difference was statistically significant(P<0.05).Conclusion When the wedge defect is less than 1/3 in width,direct resin filling can achieve good repair effect,whereas when the wedge defect is more than 1/3 but does not exceed the axial angle in width,supplementation of fiber post can improve the success rate.