本文選題：高嵌體 + 全冠��； 參考：《天津醫(yī)科大學》2017年碩士論文

【摘要】：目的本研究通過比較后牙根管治療后鑄瓷高嵌體修復(fù)與鈷鉻金屬烤瓷全冠修復(fù)的短期療效,評估根管治療后行這兩種不同的修復(fù)方式一年期間的4個方面的療效,即:修復(fù)體外形完整性、牙周健康狀況、食物嵌塞、修復(fù)體邊緣密合度,以期為臨床上后牙根管治療后修復(fù)方式的選擇提供理論依據(jù)。對象和方法收集2014年07月至2016年12月期間,就診于天津武警后勤學院附屬醫(yī)院口腔科的120例因齲病引起牙髓炎而需要做根管治療術(shù)的門診患者。入組的120例患者,年齡為22-69歲,平均年齡為35.9歲;患牙120顆,其中磨牙68顆,前磨牙52顆;上頜牙58顆,下頜牙62顆。患牙行根管治療后行牙周基礎(chǔ)治療,并在牙周基礎(chǔ)治療一周后行修復(fù)治療,120例患者,按照隨機數(shù)表隨機分配為2組進行修復(fù)治療,其中鑄瓷高嵌體組60例,男32例,女28例;鈷鉻金屬烤瓷全冠組60例,男34例,女26例。120例患者修復(fù)治療后按照3個月、6個月、12個月進行隨訪,分別從修復(fù)體外形的完整性、牙周健康、食物嵌塞和修復(fù)體邊緣密合度4個方面,評價對比這兩種修復(fù)方式的短期臨床治療效果。4個方面的具體評價指標如下:(1)修復(fù)體外形的完整性方面分四級:A代表修復(fù)體完整性良好,B代表修復(fù)體外形有小的缺損,并不影響使用,C代表修復(fù)體有折斷,D代表修復(fù)體脫落;(2)牙周健康狀況方面分三級:A代表牙周健康無炎癥,B代表輕度牙周炎癥,C代表牙周炎癥明顯,探診牙齦出血,可探及牙周袋;(3)食物嵌塞方面分二級:A代表與鄰牙鄰接關(guān)系良好,未見食物嵌塞,B代表與鄰牙鄰接關(guān)系較松,存在食物嵌塞;(4)修復(fù)體邊緣密合度方面分三級:A代表邊緣密合良好,不能用探針檢測到間隙,B代表探診探有間隙,但探針無法進入,C代表探診有間隙,探針可進入。結(jié)果比較鑄瓷高嵌體與鈷鉻金屬烤瓷全冠,在修復(fù)體外形完整性、食物嵌塞、修復(fù)體邊緣密合度這三項評價指標,均無統(tǒng)計學意義(P0.05);而牙周健康的評價指標具有統(tǒng)計學意義(P0.05)。在修復(fù)體外形完整性方面,12個月內(nèi)隨訪修復(fù)體折斷情況,鑄瓷高嵌體組與鈷鉻金屬烤瓷全冠組折斷率均為5%。從修復(fù)體脫落率分析,鑄瓷高嵌體組脫落率為7%,鈷鉻金屬烤瓷全冠組脫落率為13%。隨訪12個月牙周健康情況分析,鑄瓷高嵌體組的所有病例牙周組織均健康,達100%,而鈷鉻金屬烤瓷全冠組牙周健康,無炎癥的患者僅為82%。結(jié)論1.根管治療后鑄瓷高嵌體與鈷鉻金屬烤瓷全冠從修復(fù)體完整性、食物嵌塞、邊緣密合度這三方面短期療效相同,在牙周健康方面鑄瓷高嵌體明顯優(yōu)于鈷鉻金屬烤瓷全冠。2.就修復(fù)體外形完整性中的脫落情況而言,鈷鉻金屬烤瓷全冠比鑄瓷高嵌體更容易脫落。
[Abstract]:Objective to compare the short term effects of post root canal restoration with cast porcelain high inlay and cobalt-chromium metal fused porcelain crowns, and to evaluate the effects of these two different restoration methods in one year after root canal therapy. That is, the integrity of the prosthesis, periodontal health, food impaction, and the tightness of the restoration edge, in order to provide a theoretical basis for the selection of repair methods after the treatment of the posterior root canal. Participants and methods from July 2014 to December 2016, 120 outpatients who needed root canal therapy for dental pulpitis caused by dental caries in the Department of Stomatology, affiliated Hospital of Tianjin Armed Police Logistics College were collected. 120 patients, aged 22-69 years, with an average age of 35.9 years, had 120 teeth, including 68 molars, 52 premolars, 58 maxillary teeth and 62 mandibular teeth. After root canal treatment, 120 patients were treated with restoration therapy after one week of periodontal basic treatment. According to the random number table, 120 patients were randomly divided into 2 groups, including 60 patients in the cast porcelain hyperinlay group, 32 males and 28 females, and the patients were divided into two groups: the group with cast porcelain hyperinlay (n = 60), the group of male (n = 32), and the group of female (n = 28). There were 60 cases (34 males, 26 females) in the cobalt-chromium porcelain full crown group. The patients were followed up for 3 months, 6 months and 12 months, respectively, from the integrity of the prosthesis appearance and periodontal health, according to 3 months, 6 months, 12 months, respectively. 4 aspects of food impaction and edge tightness of restoration, To evaluate the short-term clinical therapeutic effect compared with these two methods. The specific evaluation indexes of the four aspects are as follows: 1) the integrity of the prosthesis is divided into four levels: 4% A represents good restoration integrity and B represents small defect in the shape of the prosthesis. It does not affect the use of Con C as a representative of a broken restoration, D as a representative of a prosthesis, and 2) periodontal health. In terms of periodontal health, there are three levels: a representing periodontal health and B representing periodontal health; B representing mild periodontitis; C representing periodontitis obviously; probing gingival bleeding. In the case of food impaction, there was a good relationship between the second grade: a representative and the adjacent teeth, but no food impaction B representative had a looser relationship with the adjacent teeth. There is a food inlay (4) in the case of edge tightness of the prosthesis, the third grade: a means the edge is good, the gap B can not be detected by the probe, but the probe can not enter the probe, and the probe can enter. Results there was no significant difference among the three evaluation indexes, including the integrity of the prosthesis, the food impaction and the tightness of the restoration edge, but the evaluation index of periodontal health was significantly higher than that of the cobalt chromium fused porcelain crown and the cast porcelain high inlay (P 0.05), while the evaluation index of periodontal health was significantly higher than that of the control group (P 0.05). In the aspect of the integrity of the prosthesis, the fracture rate was 5% in the cast-porcelain high inlay group and the cobalt-chromium porcelain full crown group after 12 months follow-up. The exfoliation rate of cast porcelain high inlay group was 7 and that of cobalt-chromium full crown group was 13. The periodontal health of all the patients in the cast porcelain high inlay group was healthy and 100, while that in the cobalt-chromium porcelain full crown group was 82.The periodontal health of the patients without inflammation was only 82.The periodontal health was observed in the 12 months follow up and the results showed that the periodontal tissue of all the patients in the cast porcelain high inlay group was healthy and 100. Conclusion 1. After root canal therapy, the short-term curative effect of cast porcelain high inlay was the same as that of cobalt chromium metal fused porcelain crown from three aspects: integrity of restoration, food impaction and edge tightness. It was obviously superior to cobalt chromium metal porcelain crown. 2 in periodontal health, cast porcelain high inlay was superior to cobalt chromium metal porcelain crown. In terms of the exfoliation in the integrity of the prosthesis, the cobalt-chromium porcelain full crown is easier to fall off than the high-cast porcelain inlay.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R783.3

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