树脂水门汀修复牙体缺损的临床疗效及对龈沟液相关因子水平影响

Aesthetic effect of resin-modified glass ionomer in restoring dental defects and its influence on levels of related factors in gingival crevicular fluid

目的:探讨树脂水门汀与玻璃离子粘结剂在牙体缺损修复中的临床疗效及对龈沟液TNF-α,IL-6,CRP炎症因子水平的影响。方法:选取2022年4月至2023年5月在解放军总医院京北医疗区、武汉市第九医院等多中心口腔科就诊的98例牙体缺损患者,建立编号系统,使用随机数表生成序列,将患者分为树脂水门汀组(A组)和玻璃离子粘结剂组(B组),各49例。两组患者均采用相应的材料进行牙体缺损修复,观察并记录修复后的牙龈出血率、牙龈炎、牙龈变色、出血指数(BI)、探诊深度(PD)、牙菌斑指数(PLI)、牙齿美观度评分[红色美学指数(PES)]等指标,以及龈沟液TNF-α,IL-6,CRP炎症因子水平。结果:修复后,A组的牙龈出血率(修复后3个月:14.3%vs 32.7%,χ^(2)=4.602,P=0.032;修复后6个月:12.2%vs 28.6%,χ^(2)=4.021,P=0.045;修复后12个月:4.1%vs 16.3%,χ^(2)=4.009,P=0.045)、牙龈炎发生率(修复后12个月:12.2%vs 28.6%,χ^(2)=4.167,P=0.041)、牙龈变色程度(修复后3个月:无89.8%、轻10.2%vs无79.6%、轻16.3%和中4.1%,χ^(2)=4.118,P=0.039;修复后6个月:无83.7%、轻14.3%和中2.0%vs无65.3%、轻24.5%、中8.2%和重2.0%,χ^(2)=7.835,P=0.005;修复后12个月:无77.6%、轻18.4%、中4.1%vs无51.0%、轻30.6%、中12.2%、重4.1%、极重2.0%,χ^(2)=12.467,P<0.001)、BI(修复后3个月:19.7±6.7 vs 26.3±8.1,t=4.012,P<0.001;修复后6个月:13.6±5.4 vs 21.1±7.2,t=5.421,P<0.001;修复后12个月:10.2±4.3 vs 17.3±6.1,t=6.011,P<0.001)、PD(修复后3个月:2.4±0.6 vs 2.9±0.7,t=3.621,P<0.001;修复后6个月:2.1±0.5 vs 2.6±0.6,t=4.231,P<0.001;修复后12个月:1.9±0.4 vs 2.4±0.5,t=5.142,P<0.001)、PLI(修复后3个月:21.6±7.2 vs 28.4±8.6,t=3.921,P<0.001;修复后6个月:15.4±6.1 vs 23.2±7.9,t=5.011,P<0.001;修复后12个月:12.1±5.2 vs 23.2±7.9,t=5.821,P<0.001)等指标均低于B组;A组的PES评分高于B组(修复后3个月:6.5±1.4 vs 5.7±1.5,t=2.521,P=0.014;修复后6个月:8.2±1.6 vs 7.1±1.7,t=3.011,P<0.001;修复后12个月:9.4±1.8 vs 8.2±1.9,t=3.421,P<0.001);A组的龈沟液TNF-α(修复后3个月:5.32±1.45 vs 8.69±2.28,t=8.731,P<0.001;修复后6个月:4.76±1.23 vs 8.12±2.09,t=9.699,P<0.001;修复后12个月:4.51±1.11 vs 7.85±1.98,t=10.300,P<0.001),IL-6(修复后3个月:3.45±0.89 vs 5.79±1.39,t=9.924,P<0.001;修复后6个月:3.12±0.76 vs 5.23±1.24,t=10.156,P<0.001;修复后12个月:2.98±0.71 vs 4.98±1.15,t=10.359,P<0.001),CRP(修复后3个月:2.01±0.52 vs 3.27±0.79,t=9.326,P<0.001;修复后6个月:1.85±0.47 vs 3.01±0.74,t=9.263,P<0.001;修复后12个月:1.78±0.44 vs 2.89±0.71,t=9.302,P<0.001)水平均低于B组。结论:树脂水门汀在牙体缺损修复中具有较好的美学疗效,能够有效改善患者的口腔健康和生活质量,同时能够降低龈沟液中的炎症因子水平,减少牙周炎的发生风险。

Objective:To compare the aesthetic effects and the levels of inflammatory factors TNF-α,IL-6,and CRP in gingival crevicular fluid(GCF)between resin-modified glass ionomer(RMGI)and glass ionomer adhesive(GIA)in the restoration of dental defects.Methods:A total of 98 patients with dental defects who visited multi-center dental departments such as the People’s Liberation Army General Hospital and Wuhan Ninth Hospital from April 2022 to May 2023 were enrolled in this study and randomized into resin cement group(group A)and glass ionomer adhesive group(group B),with 49 in each group.The patients in both groups recieved using corresponding materials to repair dental defects.Meanwhile,the gum bleeding rate,gingivitis,gum discoloration,bleeding index(BI),probing depth(PD),and plaque index(PLI)after repair,tooth aesthetics score[red aesthetic index(PES)]and other indicators,as well as gingival crevicular fluid TNF-α,IL-6,CRP inflammatory factor levels were recorded and comparted between the 2 groups.Results:After the repair,the gingival bleeding rate,incidence of gingivitis,degree of gingival discoloration,BI,PD,PLI and other indicators were significantly lower in group A than in group B(P<0.001).The PES score of group A was higher than that of group B(P<0.001).Gingival crevicular fluid TNF-αand CRP levels in group A were lower than those of group B(P<0.001).Conclusion:RMGI has a good aesthetic effect in the restoration of dental defects,can effectively improve the oral health and quality of life of patients,and reduce the levels of inflammatory factors in GCF,thus reducing the risk of periodontitis.