中国实用口腔科杂志

中国实用口腔科杂志

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青少年恒前牙外伤冠折后不同处理方法对牙牙合系统影响研究

郑淑珍，赵佩端   

  1. 河南省南阳市口腔医院，河南  南阳  473013
  • 出版日期:2015-05-15 发布日期:2015-07-22

  • Online:2015-05-15 Published:2015-07-22

摘要：

目的    探讨青少年恒前牙外伤后不同处理方法对患者牙牙合系统的影响。方法    将2008年在南阳市口腔医院就诊的56例青少年恒前牙外伤冠折患者经过完善根管治疗后的72颗患牙随机分为3组，分别采用纤维桩树脂核联合树脂冠修复（A组）、纤维桩树脂核联合钴铬合金烤瓷冠修复（B组）和根管治疗后待成人后再修复（C组）。随访观察5年后3组在龈炎、牙周炎、尖周病变、间隙改变、咬合改变、龈上边缘、邻面龋等方面的差异。结果    3组均无牙周炎和尖周病变出现。随着时间推移，无论何种修复，与修复初期对比，修复体颈缘终将变为龈上边缘（P＜0.05），差异有统计学意义。B组不引起间隙及咬合改变，与A、C组比较，差异有统计学意义（P＜0.05）。A组有引起邻面龋现象，与B、C组比较，差异有统计学意义（P＜0.05）。结论    纤维桩树脂核联合钴铬合金烤瓷冠修复是青少年恒前牙冠折后一种较好的过渡性修复方法，不会引起牙间隙及咬合关系的改变，不会出现邻面龋，在适宜的年龄将形成龈上边缘的外冠，去除重新更换外冠即可。

关键词: 青少年恒前牙, 冠折, 桩冠修复, 牙牙合发育

Abstract:

Objective    To investigate the influence of different rehabilitation methods for adolescent permanent anterior teeth defects on occlusion system. Methods    Totally 72 teeth，after root canal treatment，from 56 cases of adolescent patients who suffered from permanent anterior teeth trauma from Nanyang City Dental Hospital from 2008，were randomly divided into three groups：Group A，joint resin fiber post and resin core crown rehabilitation；Group B，fiber post and resin core combined with cobalt-chromium alloy porcelain crown rehabilitation；Group C，waiting for rehabilitation after root canal treatment until they become adults. Results    Five years later，the comparison in gingivitis，periodontitis，periapical lesions，the gap change， occlusal change，supragingival edge of caries and proximal dental caries was made，and Groups A，B，C had no periodontitis and periapical lesions disease. With time going on， compared with the initial rehabilitation，all the rehabilitation showed the same result： the gingival margin eventually became the supragingival edge（P＜0.05），the difference being statistically significant. Comparison was also made between the groups：group B did not cause gap and articulation change（P＜0.05），and compared with Group A and C，the difference was statistically significant；. Group A showed the proximal dental caries phenomenon（P＜0.05），and compared with Group B and C，the difference was statistically significant. Conclusion    The combined fiber post and resin core cobalt-chromium alloy porcelain crown rehabilitation is a better transition rehabilitation method for crown fracture of adolescent permanent anterior teeth，and it will not lead to tooth gap and the change in occlusion and proximal dental caries；in an appropriate age we can remove the outer edge of the crown on the edge of subgingivale to replace it with a new one.

Key words: adolescent permanent anterior teeth, crown fracture, post crown rehabilitation, occlusion growth