目的：针对穿髓型楔状缺损牙颈部抗力薄弱易折断的潜在隐患，评价不同修复术式对牙颈部抗折性能的临床效果。方法：临床随机选择穿髓型楔状缺损患者48例，牙合面完整，男性20例，女性28例，年龄45-73岁。其中第一前磨牙28例(上颌19例，下颌9例)，第二前磨牙9例(上颌6例，下颌3例)；尖牙11例(上颌8例，下颌3例)。在牙合面开髓根管治疗后，将所有患者随机分为A、 B两组各24颗牙，以2种术式分别进行修复。 A组：牙合面及楔状缺损处以Filtek Z350 XT纳米树脂完成修复； B组：根管纤维桩粘固后牙合面及楔状缺损处以Filtek Z350 XT纳米树脂完成修复。结果：临床观察2年， A组出现6例颈部折断， B组未出现颈部折断，经卡方检验连续校正公式计算，χ2=4.68， P<0.05，说明是否使用纤维桩修复与牙颈部折断间有统计学差异，使用纤维桩可增强牙颈部抗折断力。结论：在穿髓型楔状缺损根管内粘固玻璃纤维桩的一端，再以复合树脂将纤维桩的另一端与牙冠粘接，使纤维桩、树脂、整个牙齿(冠与根)三者整合为一体，不但增强了颊颈部修复体的固位，更提高了牙颈部的抗折性能，是一种合理、微创的牙颈部抗折修复形式，较好地体现了整体修复理念。%Objective:Based on the potential risk of the weakness of the severe wedge-shaped defect with exposed pulp, to evaluate the clinical efficacy of cervical anti-fracture resistance using different techniques. Methods: 48 patients, 20 males and 28 females, aged between 45 to 73 years old, with severe wedge-shaped defect, exposed pulp, and intact occlusal surfaces were enrolled to this study. 28 cases were the first premolar (19 cases maxillary and 9 cases mandibular). 9 cases were the second premolar (6 cases maxillary and 3 cases mandibular). 11 cases were the canines (8 cases maxillary and 3 cases mandibular). After root canal treatment, all the cases were randomly divided into A and B groups with 24 teeth each, and restored with two different kinds of restorations. In group A the defect was only restored by Filtek Z350 XT nano resin;while in group B the defect was first bonded with root canal fiber post followed by treatment described in group A. Results:After two years’ clinical observation, 6 cases of neck fracture were found in group A, while no neck fracture occurred in group B. Statistical significance were found between two groups, indicating that fiber post restoration can strengthen cervical anti-fracture resistance ( χ2=4.68, P<0.05 ). Conclusion: When one end of the fiber post was bonded in the root canal, and the other end was bonded to the crown, the post, resin and the entire tooth (crown and root) will become an integrated unit. It will not only improve the retention of the restoration, but also further enhanced cervical anti-fracture resistance. This is a kind of reasonable, minimally invasive restoration for tooth neck, better reflecting the overall repair concept.
展开▼
