本文選題：氧化鋯全瓷冠 + 鈷鉻合金烤瓷冠�。� 參考：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過(guò)檢測(cè)不同材料在全冠修復(fù)前、后不同時(shí)間段齦下菌斑中牙齦卟啉單胞菌(Porphyromonas gingivalis,P.g)、齒垢密螺體(Treponema denticola,T.d)、福賽坦氏菌(Tannerellaforsythensis,T.f)3種細(xì)菌檢出率,并結(jié)合牙周臨床指標(biāo)評(píng)價(jià)不同類型材料對(duì)基牙牙周組織的影響。方法:1.研究對(duì)象:選取2015年9月至2016年10月,在遼寧省人民醫(yī)院口腔科門(mén)診擬行全冠修復(fù)治療的患者,經(jīng)過(guò)入選條件嚴(yán)格篩選后作為實(shí)驗(yàn)對(duì)象。將其為兩組:氧化鋯全瓷冠組40例(男19例、女21例)和鈷鉻合金烤瓷冠組40例(男22例、女18例)。設(shè)同頜同名牙(若此牙缺失,以對(duì)頜同名牙代替)為組內(nèi)對(duì)照。所有實(shí)驗(yàn)對(duì)象年齡控制在25-65歲,氧化鋯全瓷冠組平均年齡32.60±7.93歲;鈷鉻合金烤瓷冠組平均年齡33.33±6.44歲,均同意參加本實(shí)驗(yàn),并簽定知情同意書(shū)。2.方法:采用組間、組內(nèi)相互對(duì)照研究方法,檢查并記錄受試者牙體預(yù)備前及戴全冠后三個(gè)月、六個(gè)月的觀測(cè)指標(biāo),包括牙周探診深度(Probing depth,PD)和探診出血指數(shù)(bleeding on probing,BOP)。4-site法收集受試牙齦下菌斑樣本,按照磁珠法細(xì)菌基因組DNA抽提試劑盒操作步驟提DNA,采用聚合酶鏈?zhǔn)椒磻?yīng)(Polymerase Chain Reaction,PCR),對(duì) P.g、T.d 和 T.f 的目的基因片段進(jìn)行擴(kuò)增,取一定量擴(kuò)增產(chǎn)物加樣于1.5%瓊脂糖凝膠(含Goldview-I)的加樣孔中進(jìn)行電泳,紫外線觀察儀下觀察結(jié)果。采用SPSS 22.0軟件建立數(shù)據(jù)庫(kù)并對(duì)實(shí)驗(yàn)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,不同材料全冠修復(fù)在不同時(shí)刻細(xì)菌檢出率的差異采用χ~2檢驗(yàn)。結(jié)果:1.全冠修復(fù)前:兩組在年齡和性別等一般資料,PD、BOP陽(yáng)性率、P.g、T.d、T.f檢出率等臨床指標(biāo)及實(shí)驗(yàn)室指標(biāo)上無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。2.氧化鋯全瓷冠組:實(shí)驗(yàn)組修復(fù)后三個(gè)月、六個(gè)月時(shí):PD值,P.g、T.d、T.f的陽(yáng)性檢出率與牙體預(yù)備前比較均無(wú)統(tǒng)計(jì)學(xué)不同(P0.05);BOP陽(yáng)性率與基牙牙體預(yù)備前比較均無(wú)差異。對(duì)照組觀察三個(gè)月、六個(gè)月時(shí),PD值,P.g、T.d、T.f的陽(yáng)性檢出率與之前比較無(wú)統(tǒng)計(jì)學(xué)差異(P0.05);BOP檢出率與之前比較均無(wú)差異。實(shí)驗(yàn)組與對(duì)照組比較:修復(fù)后三個(gè)月、六個(gè)月PD值,P.g、T.d、T.f的陽(yáng)性率均改變較小,無(wú)統(tǒng)計(jì)學(xué)差異(P0.05);與對(duì)照組比較,BOP的陽(yáng)性率無(wú)差異。3.鈷鉻合金烤瓷冠組(PFM):實(shí)驗(yàn)組烤瓷冠修復(fù)后三個(gè)月PD值,BOP陽(yáng)性率,P.g、T.d、T.f的檢出率與牙體預(yù)備前比較均有增加,但無(wú)統(tǒng)計(jì)學(xué)差異(P0.05);修復(fù)后六個(gè)月PD值,BOP陽(yáng)性率,P.g、T.d、T.f的檢出率與修復(fù)前比較升高,差異顯著(P0.05)。對(duì)照組觀察三個(gè)月、六個(gè)月時(shí),PD值,P.g、T.d、T.f的檢出率與之前比較變化不大,無(wú)統(tǒng)計(jì)學(xué)差異(P0.05);BOP的檢出率與之前比較均無(wú)差異。實(shí)驗(yàn)組與對(duì)照組比較:全冠修復(fù)后三個(gè)月時(shí)PD值,BOP陽(yáng)性率,P.g、T.d、T.f的陽(yáng)性檢出率,均無(wú)統(tǒng)計(jì)學(xué)差別(P0.05);修復(fù)后六個(gè)月時(shí)PD值,BOP的陽(yáng)性率,P.g、T.d、T.f陽(yáng)性檢出率,均有增加,有統(tǒng)計(jì)學(xué)差異(P0.05)。4.鈷鉻全冠組與氧化鋯全冠組:兩組之間比較:修復(fù)后三個(gè)月:鈷鉻合金全冠組PD值高于氧化鋯全冠組,差異顯著(P0.05);BOP陽(yáng)性檢出率,P.g、T.d、T.f的檢出率與氧化鋯全冠比無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。修復(fù)后六個(gè)月:PD值,BOP陽(yáng)性率,P.g、T.d、T.f的陽(yáng)性檢出率均明顯高于氧化鋯全瓷冠組,差異顯著(P0.05)。結(jié)論:1.氧化鋯全瓷冠修復(fù)后三個(gè)月、六個(gè)月時(shí),基牙牙周組織無(wú)明顯炎性改變;鈷鉻合金烤瓷冠修復(fù)六個(gè)月時(shí),基牙牙周組織呈炎癥狀態(tài)。2.氧化鋯全瓷冠修復(fù)較鈷鉻合金烤瓷冠修復(fù)更有利于維護(hù)基牙牙周組織健康。
[Abstract]:Objective: to detect the detection rate of 3 kinds of bacteria in subgingival plaque (Porphyromonas gingivalis, P.g), Treponema denticola (T.d) and Tannerellaforsythensis (T.f) in the subgingival plaque before and after the restoration of different materials, and to evaluate the different types of materials on the base teeth with the periodontal clinical indexes. The influence of periodontal tissue. Methods: 1. subjects: selected patients who were in the Department of Stomatology of the Department of Stomatology of the Liaoning Provincial People's Hospital from September 2015 to October 2016, after selected conditions were selected as the experimental subjects. They were divided into two groups: 40 cases of zirconia full porcelain crown group (male 19 cases, 21 women) and 40 cobalt chromium alloy crown group 40 cases (male) 22 cases, 18 female cases, the same name teeth of the same jaw (if the tooth is missing, instead of the same teeth of the same jaw) as the group control. The age control of all the subjects was 25-65 years old, the average age of the zirconia full porcelain crown group was 32.60 + 7.93 years old; the average age of the cobalt chromium alloy porcelain crown group was 33.33 + 6.44 years old, all with the Italy addition experiment, and signed the informed consent.2. method: adopt In the group, the intra group control study method was used to check and record the observation indexes of the subjects before and after the three months, six months after the total crown of the subjects, including the Probing depth, PD and the bleeding on probing (BOP).4-site method to collect the samples of the subgingival plaque of the subjects, and the genomic DNA extraction according to the magnetic bead method. DNA, Polymerase Chain Reaction (PCR), was used to amplify the target gene fragments of P.g, T.d and T.f, and a certain amount of amplification products were added to the 1.5% agarose gel (containing Goldview-I) in the sample hole to be electrophoretic, and the results were observed under the ultraviolet observation instrument. The software was established by SPSS 22 software. The statistical analysis of the data was carried out in the database. The difference of bacterial detection rate of the total crown of different materials at different times was tested by ~2 test. Results: before 1. full crown restoration, the two groups had no statistical difference (P0.05).2. oxidation in general data of age and sex, PD, BOP positive rate, P.g, T.d, T.f detection rate and so on. Zr all porcelain crown group: three months after the experimental group, six months after repair, the positive rate of PD, P.g, T.d, T.f was not statistically different from that before the tooth preparation (P0.05). The positive rate of BOP was not different from that before the base tooth preparation. The positive rate of PD, P.g, T.d and T.f was no statistics at three months and six months in the control group. Compared with the control group, the positive rates of PD, P.g, T.d, T.f were all smaller and no statistical difference (P0.05). The positive rate of BOP was no difference between the control group and the control group (P0.05). The positive rate of BOP was no difference between the control group and the control group (P0.05). The positive rate of BOP was not different from the control group (PFM): three months PD after the porcelain crowns were repaired in the experimental group (PFM). The positive rate of BOP, P.g, T.d, T.f increased, but there was no statistical difference (P0.05). The detection rate of BOP positive rate, P.g, T.d and T.f increased in the six months after repair, and the difference was significant (P0.05). In the control group, three months, six months, the detection rate of PD was compared with the previous changes. There was no statistical difference (P0.05); there was no difference in the detection rate of BOP. Compared with the control group, the PD value, BOP positive rate, P.g, T.d, T.f positive detection rate at three months after the crown restoration were not statistically different (P0.05); the positive rate, P.g, T.d, positive detection rates of BOP were increased. Study difference (P0.05).4. cobalt chromium full crown group and zirconia complete crown group: the comparison between the two groups: three months after repair: the PD value of CO Cr alloy whole crown group was higher than that of the whole crown group of zirconia, the difference was significant (P0.05); the positive rate of BOP, the detection rate of P.g, T.d, T.f was not statistically different from that of the total crown of zirconia (P0.05). PD value, BOP positive rate, P.g, The positive rate of T.d and T.f was significantly higher than that of the whole porcelain crown of zirconia, and the difference was significant (P0.05). Conclusion: there was no obvious inflammatory change in the periodontal tissue of the base teeth at three months after the restoration of the 1. zirconia full porcelain crown, and when the cobalt chromium alloy porcelain crown was repaired for six months, the periodontium of the base tooth periodontium was repaired with the cobalt chromium alloy grill compared with the cobalt chromium alloy. Porcelain crown restoration is more conducive to maintaining the health of abutment periodontal tissue.

【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R783.3
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本文編號(hào)：1820718