CAD/CAM纳米复合陶瓷嵌体修复儿童第一磨牙大面积缺损的临床疗效研究

Clinical observations of CAD/CAM nanocomposites inlay/on-lay of children’s first permanent molars with largearea loss

目的:观察研究一种纳米复合陶瓷修复儿童第一磨牙大面积牙体缺损的临床效果。方法:针对临床上29例年龄7~15岁,第一磨牙大面积牙体缺损的患者(共35颗),使用CAD/CAM纳米复合陶瓷进行修复,13颗嵌体和22颗高嵌体。修复后24个月内分别对患者进行修复体形状、色泽、舒适性的满意度调查,使用改良的美国公共卫生服务(United States Public Health Service,USPHS)标准分别评价修复后即刻、12个月和24个月时的临床疗效,评价项目包括修复体完整性、继发龋、边缘适合性、牙龈健康状况和磨耗程度。结果:35颗患牙修复后即刻、24个月修复体形状和舒适性主观评价满意度均达100%,24个月时色泽满意度下降为91.4%。修复体完整性、继发龋以及牙龈健康状况24个月内均100%达到A级。边缘适合性12个月时均达到A级,24个月时88.6%(31例)达到A级,有统计学差异。磨耗程度上,12个月、24个月的临床效果有明显差异,12个月时20%(7例)修复体面出现了小的磨耗平面,24个月时达到了45%(16例),并有17%(6例)出现了较大的磨耗平面,修复体的解剖形态均较好。结论:CAD/CAM纳米复合陶瓷嵌体可以作为儿童第一磨牙大面积牙体缺损的有效治疗方案,疗效稳定,满意度高。

Objective:To explore the therapeutic efficacy of CAD/CAM nanocomposites in children with first permanent molars with large-area loss.Methods:35 first permanent molars with large-area loss from 29 children between the ages of 7 and 15 years were selected.After careful tooth preparation,a total of 35 restorations(13 inlays,22 onlays)were designed and manufactured using the CAD/CAM system.Within 24 months,the patients’subjective satisfaction were assessed regardingrestoration shape,color and comfort.The improved United States Public Health Service(USPHS)standard was used toevaluate the clinical efficacy immediately,12 and 24 months after the restoration.The evaluation items included theintegrity of the restoration,secondary caries,marginal fitness,gingival health and abrasion.Results:For the 35 restorations,the subjective satisfaction of the patients about restoration shape and comfort immediately and 24 months after treatment wereboth 100%.At 24 months after treatment,the satisfaction with color decreased to 91.4%.100%of the teeth were grade A forintegrity,secondary caries and gingival health within 24 months.Regarding the marginal adaptation,teeth of grade A were100%at 12 months,and 88.6%(31 cases)at 24 months after treatment,with statistical differences.In terms of abrasion,theclinical effects at 12 and 24 months were significantly different.At 12 months,20%(7 cases)of the restoration hada small abrasion surface,and reached 45%at 24 months(16 cases),and 17%(6 cases)showed a large abrasion plane,but theanatomical shape of the restoration was acceptable.Conclusion:The application of CAD/CAM nanocomposites had a clearcurative effect and resulted in high satisfaction in the restoration of permanent molars with large-area loss in children.