本文選題：年輕患者恒前牙 + 冠折　； 參考：《浙江大學(xué)》2014年碩士論文

【摘要】：目的： 研究年輕患者恒前牙冠折后使用纖維樁連接粘結(jié)斷冠的過(guò)渡性修復(fù)的臨床療效,探討影響斷冠再接效果的因素。 方法： 110例(135顆)冠折斷端保留完整的年輕患者恒前牙冠折患者分為直接粘結(jié)組(26例,30顆)及纖維樁粘結(jié)組(84例,105顆),纖維樁粘結(jié)組再按門診就診順序號(hào)隨機(jī)分成LuxaCore組和RelyX Unicem組,其中LuxaCore組(42例,53顆)再按折斷部位位于中1/3或頸1/3處折斷分為中1/3折斷組(19例,24顆)和頸1/3折斷組(23例,29顆),RelyX Unicem組(42例,52顆)再按折斷部位分為中1/3折斷組(20例,23顆)和頸1/3折斷組(22例,29顆)；另67例(77顆牙)冠折斷端缺失的年輕患者恒前牙冠折患者納入纖維樁+樹(shù)脂修復(fù)組做為對(duì)比參照。直接粘結(jié)組采用直接粘結(jié)再接自體斷冠,纖維樁粘結(jié)組采用纖維樁連接再接自體斷冠,纖維樁+樹(shù)脂修復(fù)組采用纖維樁+樹(shù)脂修復(fù)斷冠,經(jīng)過(guò)6個(gè)月至2年以上的臨床隨診觀察至成年后改為永久性修復(fù)。過(guò)渡性修復(fù)后及永久性修復(fù)前對(duì)患者采用自制滿意度評(píng)價(jià)量表進(jìn)行滿度度評(píng)價(jià)并進(jìn)行永久性修復(fù)的意向調(diào)查。對(duì)選擇不去除粘結(jié)斷端而直接牙備后全冠永久性修復(fù)的患者繼續(xù)隨訪觀察修復(fù)效果。 結(jié)果： 1年內(nèi)LuxaCore組和RelyX Unicem組二組成功率均為100%,高于直接粘結(jié)組的93.33%,差異有統(tǒng)計(jì)學(xué)意義(卡方檢驗(yàn),x2=7.1053,P0.05)。LuxaCore組1年～2年的成功率為92.86%,RelyX Unicem組為92.68%,均高于直接粘結(jié)組的73.91%,差異有統(tǒng)計(jì)學(xué)意義(卡方檢驗(yàn),x2=6.3803,P0.05)。LuxaCore組2年以上的成功率為84.62%,RelyX Unicem組為81.82%,均高于直接粘結(jié)組的53.33%,兩者比較差異有統(tǒng)計(jì)學(xué)意義(卡方檢驗(yàn),x2=6.033,P0.05)。纖維樁粘結(jié)組中的中1/3折斷組再接成功率高于頸1/3折斷組,但兩者比較差異無(wú)統(tǒng)計(jì)學(xué)意義。纖維樁粘結(jié)組中選擇不去除粘結(jié)斷端而直接牙備后全冠永久性修復(fù)21例,失敗1例,失敗率4.76%,與纖維樁+樹(shù)脂修復(fù)組失敗率無(wú)差異。 即刻修復(fù)滿意度調(diào)查提示纖維樁粘結(jié)組滿意度評(píng)分為8.41±1.41,高于直接粘結(jié)組的7.67+2.09和纖維樁+樹(shù)脂修復(fù)組的6.58±1.37,差異有統(tǒng)計(jì)學(xué)意義(t檢驗(yàn),P0.05)。長(zhǎng)期滿意度調(diào)查提示纖維樁粘結(jié)組滿意度評(píng)分為6.15±1.76,高于直接粘結(jié)組的4.58±2.27和纖維樁+樹(shù)脂修復(fù)組的4.30±1.35,差異有統(tǒng)計(jì)學(xué)意義(t檢驗(yàn),P0.01)。改為永久性修復(fù)的意向進(jìn)行調(diào)查結(jié)果表明原修復(fù)體美觀,功能良好是不愿改為永久性修復(fù)的主要原因,其中纖維樁粘結(jié)組比例最高,達(dá)72.97%,高于纖維樁+樹(shù)脂修復(fù)組55.81%。 失敗病例影響因素分析中,在咬合關(guān)系因素上,直接粘結(jié)組中正常咬合病例的失敗率低于深覆合覆蓋病例,兩者比較差異有統(tǒng)計(jì)學(xué)意義(卡方檢驗(yàn),x2=6.2382,P0.05)。在牙根發(fā)育情況因素上,纖維樁粘結(jié)組中牙根未發(fā)育完成病例的失敗率高于已完成病例,兩者比較差異有統(tǒng)計(jì)學(xué)意義(卡方檢驗(yàn),x2=6.0287,P0.05)。在外傷牙松動(dòng)情況因素上,纖維樁粘結(jié)組中Ⅰ°松動(dòng)病例的失敗率高于不松動(dòng)病例,兩者比較差異有統(tǒng)計(jì)學(xué)意義(卡方檢驗(yàn),x2=5.564,P0.05)。在折斷線位置因素上,直接粘結(jié)組中折斷線位置位于齦上的失敗率低于位于齦下病例,兩者比較差異有統(tǒng)計(jì)學(xué)意義(卡方檢驗(yàn),x2=5.5767,P0.05),纖維樁粘結(jié)組中折斷線位置位于齦上的失敗率低于位于齦下病例,兩者比較差異有統(tǒng)計(jì)學(xué)意義(卡方檢驗(yàn),x2=25.556,P0.01)。 結(jié)論： 使用纖維樁連接自體牙冠過(guò)渡性修復(fù)年輕患者恒前牙冠,療效肯定,優(yōu)于直接粘結(jié)及纖維樁+樹(shù)脂修復(fù),患者即刻及長(zhǎng)期滿意度高,又不影響后期的永久修復(fù),是一種良好的過(guò)渡性修復(fù)方法；修復(fù)過(guò)程應(yīng)注意折斷部位、咬合關(guān)系、牙根發(fā)育情況、牙松動(dòng)情況、折斷線位置對(duì)修復(fù)成功率的影響。
[Abstract]:Purpose :

To study the clinical curative effect of the transitional repair using fiber - pile to bond the broken crown after the anterior tooth crown was folded in young patients , and the factors influencing the effect of crown re - grafting were discussed .

Method :

In 110 cases ( 135 teeth ) , the intact young patients were divided into direct bonding group ( 26 cases , 30 teeth ) and fiber pile bonding group ( 84 cases , 105 ) , and the fiber pile bonding group was randomly divided into LuxaCore group and RelyX Unicem group according to the outpatient treatment sequence number . The LuxaCore group ( 42 cases , 53 ) was broken into 1 / 3 fracture group ( 23 cases , 29 ) and RelyX Unicem group ( 42 cases , 52 ) were divided into 1 / 3 fracture group ( 20 cases , 23 ) and 1 / 3 fracture group ( 22 cases , 29 ) .
In another 67 cases ( 77 teeth ) were treated with fiber pile + resin restoration group by using fiber pile + resin restoration group as contrast reference . The direct bonding group used fiber pile + resin to repair the broken crown . After 6 months to more than 2 years , the self - made satisfaction evaluation scale was used to evaluate the degree of fullness and to conduct permanent repair .

Results :

The two components of LuxaCore group and RelyX Unicem group were 100 % in 1 year and 93.33 % higher than that in the direct bonding group ( Chi - square test , x2 = 7.53 , P0.05 ) . The success rate of LuxaCore group from 1 year to 2 years was 92.86 % , and the RelyX Unicem group was 92.68 % , which was higher than 73.91 % in the direct bonding group ( Chi - square test , x2 = 6.3803 , P0.05 ) . The success rate of LuxaCore group was 84.62 % in 2 years , and the RelyX Unicem group was 81 . 82 % , which was higher than 53.33 % in the direct bonding group . The difference was statistically significant ( chi - square test , x2 = 6.33 , P0.05 ) . In the fiber pile bonding group , the success rate of the 1 / 3 fracture group was higher than that of the 1 / 3 fracture group , but there was no significant difference between the two groups . In the fiber pile bonding group , 21 cases were permanently repaired without removal of the bonded fracture end , 1 case failed , the failure rate was 4.76 % , and the failure rate of the fiber pile + resin repair group was no difference .

The results of immediate repair satisfaction showed that the satisfaction score of fiber pile was 8.41 鹵 1.41 , which was higher than 7.67 + 2.09 in the direct bonding group and 6.58 鹵 1.37 in the fiber pile + resin repair group ( t test , P0.05 ) . Long - term satisfaction survey showed that the satisfaction score of fiber - pile bonding group was 6.15 鹵 1.76 , which was higher than 4.58 鹵 2.27 in the direct bonding group and 4.30 鹵 1.35 in fiber pile + resin repair group ( t - test , P0.01 ) . The results showed that the original prosthesis was attractive and the function was good . The result showed that the ratio of fiber pile was the highest , which reached 72.97 % , which was higher than 55.81 % of the fiber pile + resin repair group .

In the analysis of the influencing factors of failure cases , the failure rate of normal occlusion cases in the direct bonding group was lower than that in the case of deep covering , and the difference was statistically significant ( chi - square test , x2 = 6.2382 , P0.05 ) . In the case of root development , the failure rate of tooth root in the fiber pile bonding group was higher than that in the completed case , and the difference was statistically significant ( Chi - square test , x2 = 6.0287 , P0.05 ) . In the case of traumatic tooth loosening , the failure rate of 鈪，

本文編號(hào)：1796415