中国实用口腔科杂志

中国实用口腔科杂志

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钴铬合金烤瓷冠和全瓷冠修复对患牙牙周组织及龈沟液中炎症因子水平的影响研究

马玉龙，王海山，那日苏   

  1. 内蒙古赤峰市医院口腔科，内蒙古  赤峰  024000
  • 出版日期:2016-12-15 发布日期:2017-01-17

  • Online:2016-12-15 Published:2017-01-17

摘要：

目的    探讨钴铬合金烤瓷冠和全瓷冠修复对患牙牙周组织及龈沟液（GCF）中炎症因子水平的影响。方法      选择2014年9月至2015年3月来内蒙古赤峰市医院口腔科就诊的67例上颌前牙牙体缺损需行全冠修复的患者（共97颗患牙），将所有患牙随机分配到钴铬合金烤瓷冠组（A组，42颗）和全瓷冠组（B组，55颗）。于修复前、修复后1个月、3个月测定患牙牙周组织各项指标［包括牙龈指数（GI）、龈沟探诊深度（GCD）、GCF量］及GCF中白细胞介素（IL）-8、基质金属蛋白酶（MMP）-8和肿瘤坏死因子（TNF）-α的水平。结果    修复前A、B两组间患牙牙周组织各项指标（GI、GCD、GCF量）及GCF中IL-8、MMP-8和TNF-α的水平差异均无统计学意义。对比修复前，修复后1个月和3个月时间点，A、B两组患牙牙周组织各项指标（GI、GCD、GCF量）以及GCF中IL-8、MMP-8和TNF-α的水平差异均有统计学意义（P < 0.05）。修复后1个月，A、B两组间患牙GCF中IL-8、MMP8及TNF-α的水平差异有统计学意义（P < 0.05），而牙周组织各项指标（GI、GCD、GCF量）差异无统计学意义（P > 0.05）。修复后3个月，A、B两组间患牙牙周组织各项指标（GI、GCD、GCF量）及GCF中IL-8、MMP-8和TNF-α的水平差异均有统计学意义（P < 0.05）。 结论     采用钴铬合金烤瓷冠可导致患牙牙周GCF量及GCF中炎症因子水平的升高，不利于牙周组织的恢复，远期治疗效果欠佳，全瓷冠对局部牙周组织影响相对较小，远期疗效好。

关键词: 钴铬合金烤瓷冠, 全瓷冠, 口腔修复, 龈沟液

Abstract:

Objective    To detect the effect of the restoration with Co-Cr alloy porcelain crown and all-ceramic crown on periodontal tissue and the level of inflammatory factorsin gingival crevicular fluid. Methods    From September 2014 to March 2015， totally 67 patients （97 teeth）with complete crown restoration in our hospital were randomly divided into Co-Cr alloy porcelain crown group （group A） and all-ceramic crown group （group B）. The gingival index （GI）， gingival sulcus probing depth （GCD）， amount of gingival sulcus fluid （GCF）， and IL-8， MMP-8 ，TNF- α in GCF were measured before and one month and 3 months after restoration. Results    There was no significant difference on the GI， GCD， amount of GCF， and  the levels of  IL-8， MMP-8 and TNF-αin GCF between the two groups before treatment. Compared with before treatment，at 1 month and 3 months after treatment， GI， GCD， amount of GCF， and IL-8，MMP-8， TNF-α levels in GCF were statistically significant （P < 0.05）. There were significant differences on IL-8， MMP8 and TNF-α level in GCF between group A and B at 1 month after repair， and there were no significant differences on GI， GCD and amount of GCF. After 3 months of repair，groups A and B were significantly different on all the detection indicators （P < 0.05）. Conclusion    As the crown of Co-Cr alloy porcelain crown can lead to elevated amount of periodontal GCF and levels of inflammatory factors in GCF，it is not conducive to periodontal tissue recovery； the long-term effect is poor. The effect of all ceramic crown on the periodontal tissue is relatively small，and the long-term curative effect is good.

Key words: cobalt chromium alloy porcelain crown, all- ceramic crown, dental restoration, gingival sulcus fluid