CAJ | 학술논문

目的：探讨临床活髓牙固定修复术后敏感发生的原因与治疗方法。方法2010年1月-2013年1月13例固定修复后3个月以上患者，术后冷水敏感不缓解，或牙龈炎伴敏感就诊，包括43颗活髓牙，经旧修复体拆除，牙周治疗，局麻下重新规范牙体预备，除两颗前牙基牙因经冠延长术后重新调整冠根比需要，进行了根管治疗外，其余41颗均保存活髓，临时冠丁香油氧化锌粘固粉暂粘，两周复诊过敏症状消失，牙龈健康，聚醚橡胶取模完成修复体制作，玻璃离子水门汀粘接。记录再修复术后即刻，3个月，半年牙髓冷水敏感状况，复查牙龈指数（GI），龈沟出血指数（ SBI）。结果13例41颗活髓基牙再修复均无粘接后即刻敏感。3个月，半年复诊牙龈健康，GI：0～1分，SBI：1分，无冷水敏感发生。结论活髓基牙固定修复经规范正确的牙体预备，临时修复体选择合适的暂时粘接材料促进牙髓牙本质复合体创伤愈合，修复体精密的制作，及严格的边缘封闭对消除术后敏感都是不可或缺的方面。一味追求少磨切牙体组织而产生有倒凹的牙体预备并不能减少术后敏感的发生。
목적：탐토림상활수아고정수복술후민감발생적원인여치료방법。방법2010년1월-2013년1월13례고정수복후3개월이상환자，술후랭수민감불완해，혹아간염반민감취진，포괄43과활수아，경구수복체탁제，아주치료，국마하중신규범아체예비，제량과전아기아인경관연장술후중신조정관근비수요，진행료근관치료외，기여41과균보존활수，림시관정향유양화자점고분잠점，량주복진과민증상소실，아간건강，취미상효취모완성수복체제작，파리리자수문정점접。기록재수복술후즉각，3개월，반년아수랭수민감상황，복사아간지수（GI），간구출혈지수（ SBI）。결과13례41과활수기아재수복균무점접후즉각민감。3개월，반년복진아간건강，GI：0～1분，SBI：1분，무랭수민감발생。결론활수기아고정수복경규범정학적아체예비，림시수복체선택합괄적잠시점접재료촉진아수아본질복합체창상유합，수복체정밀적제작，급엄격적변연봉폐대소제술후민감도시불가혹결적방면。일미추구소마절아체조직이산생유도요적아체예비병불능감소술후민감적발생。
Objective To find treatment methods of postoperative sensitivity in fixed denture of vital pulp abutment teeth . Methods From 2010 to 2013 there were 13 cases, including 43 vital pulp teeth wearing crowns or bridges , for which post-operative sensitivity lasted more than three months .The old dentures were removed , periodontal treatments were done , then under local anesthesia the abutment teeth were re -prepared .Temporary crowns were made and bonded using zinc oxide eugenol cement .Forty-one teeth of vital pulp were conserved except the root canals of two front teeth , which were treated because of adjusting the crown -root ratio after crown lengthening .Sensitive symptoms disappeared at visit after two weeks , and gingival was healthful .The impression of polyether rubber was done and new restorations were finished and bonded u -sing glass ionomer cement .The indexes were recorded , including pulp immediately cold sensitivity , gingival index ( GI) and sulcus bleeding index ( SBI) at the subsequent visits in three months and six months .Results Thirteen cases of 41 vital pulp teeth did not have the symptom of immediately sensitivity after being bonded .In the first three and six months , the gingival were healthful , and did not have any sensitivity of cold water .Conclusion The strict processes were essential fac-tors to prevent vital pulp abutment from postoperative sensitivity , including tooth preparation correctly , making provisional restorations and selecting suitable temporary bonding material to promote pulp -dentin complex wound healing , making pre-cise closed edge restoration .It didn't reduce postoperative sensitivity by undercuting tooth preparation for less grinding tooth tissues.