纯钛铸造分裂桩冠修复低(牙合)龈距离且根分叉较大磨牙的临床效果评价

摘要

目的:观察分裂桩冠和分裂桩核冠修复低(牙合)龈距离且根分叉较大后牙的临床效果,阐明其应用优势并分析其改进方法.方法:选取29例患者的49颗完善根管治疗的低(牙合)龈距离磨牙残根,参考患者意愿随机分为分裂桩冠组23颗和分裂桩核冠组26颗,分别进行分裂桩冠或分裂核桩冠修复,观察2组患牙术后12和24个月后的修复成功率,比较戴牙12个月后龈沟液中基质金属蛋白酶8(MMP-8)含量.结果:分裂桩冠组在治疗后12和24个月的修复成功率分别为95.7％和82.6％,修复成功率比较差异无统计学意义(P＞0.05);分裂核桩冠组在治疗后12和24个月的修复成功率分别为84.6％和52.2％,修复成功率比较差异有统计学意义(P＜0.05).在治疗后24个月,分裂桩冠组的修复成功率明显高于分裂核桩冠组(P＜0.05);2组患者龈沟液中MMP-8含量比较差异无统计学意义(P＞0.05).结论:分裂桩冠用于低(牙合)龈距离磨牙残根修复在24个月随访期内临床效果明显优于分裂核桩冠,针对性地加以改进有助于提高临床修复成功率.%Objective:To observe the clinical effects of split post crown and split post-core crown in restoring the molars with low occlusogingival distance and large root furcation,and to clarify its advantages and analyze its improvement methods.Methods:Forty-nine molars of twenty-nine patients,which had been completely treated with root canal therapy,were restored by split post crown or split post-core crown according to their wills.Split post crown was used in twenty-three cases,and split post core crown was applied in the other twenty-six cases.The clinical effects of the patients in two groups were observed after 12 and 24 months follow-up.The levels of MMP-8 in gingival crevicular fluid were checked and compared 12 months after restoration.Results:The restoration success rates of split post crown were 95.7％ after 12-month treatment and 82.6 ％ after 24-month treatment,respectively;there was no significant difference between them (P＞ 0.05).The success rates of split post-core crown were 84.6％ after 12-month treatment and 52.2％ after 24-month treatment,respectively;there was significant difference between them (P＜0.05).The success rate of split post crown was significantly higher than that of split post-core crown after 24-month treatment (P＜0.05).The levels of MMP-8 in gingival crevicular fluid of the patients were close to each other,there was no statistical significance (P＞0.05).Conclusion;The split post crown shows better clinical effect in restoring the molars with low occlusogingival distance in 24 months than split postcore crown.Targeted improvement will help to improve the clinical success rate.