中华老年口腔医学杂志
中華老年口腔醫學雜誌
중화노년구강의학잡지
CHINESE JOURNAL OF GERIATRIC DENTISTRY
2014年
3期
165-168
,共4页
穿髓型楔状缺损%玻璃纤维桩%根管治疗%预防%牙折%微创
穿髓型楔狀缺損%玻璃纖維樁%根管治療%預防%牙摺%微創
천수형설상결손%파리섬유장%근관치료%예방%아절%미창
wedge-shaped defect%glass fiber post%root canal therapy%prevention%tooth fracture%minimally invasive
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。
目的：針對穿髓型楔狀缺損牙頸部抗力薄弱易摺斷的潛在隱患，評價不同脩複術式對牙頸部抗摺性能的臨床效果。方法：臨床隨機選擇穿髓型楔狀缺損患者48例，牙閤麵完整，男性20例，女性28例，年齡45-73歲。其中第一前磨牙28例(上頜19例，下頜9例)，第二前磨牙9例(上頜6例，下頜3例)；尖牙11例(上頜8例，下頜3例)。在牙閤麵開髓根管治療後，將所有患者隨機分為A、 B兩組各24顆牙，以2種術式分彆進行脩複。 A組：牙閤麵及楔狀缺損處以Filtek Z350 XT納米樹脂完成脩複； B組：根管纖維樁粘固後牙閤麵及楔狀缺損處以Filtek Z350 XT納米樹脂完成脩複。結果：臨床觀察2年， A組齣現6例頸部摺斷， B組未齣現頸部摺斷，經卡方檢驗連續校正公式計算，χ2=4.68， P<0.05，說明是否使用纖維樁脩複與牙頸部摺斷間有統計學差異，使用纖維樁可增彊牙頸部抗摺斷力。結論：在穿髓型楔狀缺損根管內粘固玻璃纖維樁的一耑，再以複閤樹脂將纖維樁的另一耑與牙冠粘接，使纖維樁、樹脂、整箇牙齒(冠與根)三者整閤為一體，不但增彊瞭頰頸部脩複體的固位，更提高瞭牙頸部的抗摺性能，是一種閤理、微創的牙頸部抗摺脩複形式，較好地體現瞭整體脩複理唸。
목적：침대천수형설상결손아경부항력박약역절단적잠재은환，평개불동수복술식대아경부항절성능적림상효과。방법：림상수궤선택천수형설상결손환자48례，아합면완정，남성20례，녀성28례，년령45-73세。기중제일전마아28례(상합19례，하합9례)，제이전마아9례(상합6례，하합3례)；첨아11례(상합8례，하합3례)。재아합면개수근관치료후，장소유환자수궤분위A、 B량조각24과아，이2충술식분별진행수복。 A조：아합면급설상결손처이Filtek Z350 XT납미수지완성수복； B조：근관섬유장점고후아합면급설상결손처이Filtek Z350 XT납미수지완성수복。결과：림상관찰2년， A조출현6례경부절단， B조미출현경부절단，경잡방검험련속교정공식계산，χ2=4.68， P<0.05，설명시부사용섬유장수복여아경부절단간유통계학차이，사용섬유장가증강아경부항절단력。결론：재천수형설상결손근관내점고파리섬유장적일단，재이복합수지장섬유장적령일단여아관점접，사섬유장、수지、정개아치(관여근)삼자정합위일체，불단증강료협경부수복체적고위，경제고료아경부적항절성능，시일충합리、미창적아경부항절수복형식，교호지체현료정체수복이념。
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.
