目的 探讨后牙金铂合金全金属颈环烤瓷熔附金属全冠(porcelain fused to metal ,PFM)的应用价值。方法 选取99例进行后牙金铂合金PFM修复的患者,共修复牙体182颗,其中93颗牙体采用金铂合金PFM全金属颈环羽状肩台设计,89颗牙体采用凹面肩台设计,戴冠1年和3年后,比较两组设计边缘适应性、牙龈健康状况、继发龋发病率、牙龈染色及稳定性的差异。结果 戴冠1年后,两组设计边缘适应性、牙龈健康状况、继发龋发病率及牙龈染色无明显差异。戴冠3年后,后牙金铂合金全金属颈环PFM边缘适合性优的比例(92.47%)高于凹面肩台PFM设计(82.02%);后牙金铂合金全金属颈环PFM造成牙龈病变的比例及继发龋的比例(18.28%和3.22%)低于凹面肩台PFM(34.83%和11.24%);前者牙龈染色的程度重于后者,差异有统计学意义(P<0.05)。后牙金铂合金全金属颈环PFM随着时间推移缘适应性、牙龈健康状况、继发龋发病率无明显变化,而凹面肩台设计PFM的以上指标均向不利方向发展(P<0.05)。结论 后牙金铂合金全金属颈环PFM具有良好的边缘适应性、稳定性、较低的牙龈病变的比例及继发龋的比例,但造成牙龈染色的概率较大。后牙金铂合金全金属颈环PFM可作为后牙区修复的一种常规设计方案。
Abstract
Objective To study the application value of Au-Pt alloy porcelain fused to metal(PFM)of full metal margin to posterior teeth. Methods 99 patients with Au-Pt alloy PFM restoration were recruited. 182 posterior teeth were restored. 93 posterior teeth were restored with Au-Pt alloy PFM of full metal margin, 89 posterior teeth were restored with Au-Pt alloy PFM of concave shoulder. After 1 and 3 years, the clinical effect in marginal adaptation /gigival health /secondary caries /the color of the gingiva and the stability were observed. The clinical effect in marginal adaptation/gigival health and secondary caries of posterior teeth of Au-Pt alloy PFM of full metal margin had not obvious change, but they were to the adverse direction about Au-Pt alloy PFM of concave shoulder (P<0.05). Results One year later, the clinical effect on marginal adaptation /gigival health /secondary caries and the color of the gingival had no significant difference between the two groups. Three years later, The good proportion of marginal adaptation of Au-Pt alloy PFM of full metal margin(92.47%) was better than Au-Pt alloy PFM of concave shoulder(82.02%). The proportion of periodontal lesions and secondary caries of the former (18.28% and 3.22%)were better than the latter(34.83% and 11.24%). The degree of the former gum being shaded was worse than the latter, the differences was statistically significant (P<0.05). Conclusions In the long run, posterior teeth restored with Au-Pt alloy PFM of full metal has good margin marginal adaptation / lower gum disease rate and secondary caries rate, but gum has greater risk of dyeing. Posterior teeth of Au-Pt alloy PFM of full metal margin can be recommended as clinical routine design.
关键词
烤瓷熔附金属全冠 /
金属颈环 /
边缘适合性 /
牙龈 /
继发龋
Key words
porcelain fused to metal /
full metal margin /
marginal adaptation /
gigiva /
secondary caries
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参考文献
[1] 刘文娟.钴铬合金烤瓷冠与镍铬合金烤瓷冠的临床应用效果对比[J].临床和研究医学杂志,2015,14(9): 739-742.
[2] Gemalmz D, Ergin S .Clinical evaluation of all-ceramic crowns[J].J Prosthet Dent,2002,87(2):189-195.
[3] 周 艳,谷志远. IPS e.max press LT 易美铸瓷低度透明瓷块铸造全冠修复后牙缺损的临床观察[J].口腔医学,2010,30(4):224-226.
[4] Gemalmz D, Ergin S. Clinical evaluation of all-ceramic crowns[J].J Prosthet Dent, 2002,87(2):189-195.[5] 许宏一,徐培成,钱文昊,等.选择性激光熔覆技术与失蜡铸造法制作的钴铬合金基底冠的边缘适应性的比较[J].中国临床医学, 2013,20(06): 843-844.
[6] 吴 丹,孙 健.全冠修复体适合性的研究方法[J].临床口腔医学杂志,2012,28(6):376-377.
[7] Albert F E,EI-Mowafy O M.Marginal adaptation and microleakage of procera all ceram crowns with four cements[J] .Int J Prosthodont, 2004,17(5):529-535.
[8] BindI A,Mǒrmann W H.Fit of all-ceranaic posterior fixed partial denture frameworks in vitro [J].Int J Periodontics Restorative Dent, 2007,27(6):567-575.
[9] 刘 峰.美学修复牙体预备[M].北京:人民卫生出版社,2013:35.
[10] 姚 希,李昀生,谢 雷,等. 不同后牙固定桥材料的临床应用[J].中国组织工程研究,2012,16(47): 8787-8793.
[11] 马庆云,任 甫,李 新,等.口腔常用铸造金属桩核对磁共振成像的影响[J].实用口腔医学杂志,2014,30(4):460-463.
[12] 姚 希,李昀生,胡冬梅,等.不同材料烤瓷冠在后牙种植修复中的对比[J].中国组织工程研究,2014,18(12):1858-1863.
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