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中华口腔医学研究杂志(电子版) ›› 2012, Vol. 6 ›› Issue (01) : 57 -64. doi: 10.3877/cma.j.issn.1674-1366.2012.01.010

临床研究

Tenax Fiber White 玻璃纤维桩修复前牙残根残冠
王家安1, 张新春2,()   
  1. 1.517000 广东省河源市人民医院口腔医疗中心
    2.中山大学光华口腔医学院·附属口腔医院,广东省口腔医学重点实验室
  • 收稿日期:2011-04-22 出版日期:2012-02-01
  • 通信作者: 张新春

Application and analysis of esthetic restoration of anterior residual roots and crowns by Tenax Fiber White glass fiber posts and all ceramic crowns

Jia-an WANG1, Xinchun ZHANG,1()   

  1. 1.Centre of Stomatology, Heyuan People's Hospital, Heyuan 517000, China
  • Received:2011-04-22 Published:2012-02-01
  • Corresponding author: Xinchun ZHANG
引用本文:

王家安, 张新春. Tenax Fiber White 玻璃纤维桩修复前牙残根残冠[J/OL]. 中华口腔医学研究杂志(电子版), 2012, 6(01): 57-64.

Jia-an WANG, Xinchun ZHANG. Application and analysis of esthetic restoration of anterior residual roots and crowns by Tenax Fiber White glass fiber posts and all ceramic crowns[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2012, 6(01): 57-64.

目的

评价Tenax Fiber White 玻璃纤维桩加全瓷冠修复前牙残根残冠的临床效果。

方法

对42 例64 颗已行完善根管治疗的前牙残根残冠进行玻璃纤维桩核加全瓷冠修复。 按照牙体预备后余留牙本质高度分为3 组,A 组余留牙体高度大于等于2 mm,B 组高度小于2 mm 并大于或等于1 mm,C 组高度小于1 mm。 治疗完成后1、6、12、24 个月复查,评价修复体完整性,边缘适合度,牙周组织健康状况及根尖周健康状况等疗效。

结果

95.3%的修复体保持完整。 有2 例修复体发生桩脱位,其中1 例伴有崩瓷,为咬硬物所致,1 例根管粗大。另有1 例发生纤维桩折断,牙龈充血。 余留牙体在0 ~1 mm 组无箍效应,修复失败率增加(P <0.05)。 全瓷冠类型无明显影响。 其他所有修复体边缘适合性良好,色泽稳定,牙龈状况良好。 X 线片未见根尖异常,未见根折或桩折。

结论

纤维桩全瓷冠修复效果除了与牙本质肩领高度有关,还与余留牙本质的性状有关,临床选择应综合考虑。 在符合适应证的情况下,Tenax Fiber White 玻璃纤维桩和全瓷冠修复可获得良好修复效果。

Objective

To evaluate the effect of the glass fiber-reinforced posts with all ceramic crowns on restoration of the residual roots and crowns in the anterior teeth.

Methods

64 anterior residual roots and crowns from 42 cases after root canal therapy were restored by glass fiber-reinforced posts and all ceramic crowns. According to the height of residual dentin, they were divided into three groups: Group A, in which the height of dentin collar was no less than 2 mm; Group B, between 1 and 2 mm; and Group C, less than 1 mm. Clinical and radiographic examinations were conducted and recorded after 1, 6, 12, and 24 month.

Results

95.3%restorations were successful, with satisfied marginal adaptation and healthy gingiva. No dislodgment or fracture of posts or roots was observed in clinical and radiographic examination. However, 3 restorations were failed. In two cases, the fiber posts were dislodged either by biting hard food or by the flared root canal, and in another one, the post was fractured and gingivitis occurred.Group C had significantly higher restoration failure due to the absent of the ferrule effect (P <0.05).

Conclusions

This study indicated that the effect of the restoration with fiber-reinforced post and all ceramic crown depended on both heights and properties of residual dentine. The application of Tenax Fiber White glass fiber-reinforced post and all ceramic crown would be a good choice for restoration of anterior residual crowns and roots When meeting the requirements of indication.

表1 桩核冠修复体的临床评价标准
指标 评价 标准
边缘适合性 不卡探针,无可见裂隙,边缘探诊光滑
可接受 可见微小裂隙,探针在一个方向上卡住无龋坏,可修补但并非必需;无龋坏;或修复体和牙体组织边缘变色
不可接受 边缘有缺陷不能完全修补;或沿修复体边缘向牙髓方向可探入变色区;或余留多余的水门汀;或修复体松动;或修复体边缘连续龋坏;或牙体组织折裂
修复体完整性 修复体表面完整,无任何可见的裂纹或折裂
可接受 修复体可见裂纹,但未完全折裂
不可接受 修复体完全折裂或脱落
解剖外形 修复体与牙体外形连续,外形良好,与邻牙及软组织功能协调,
可接受 修复体外形轻微低于或超出牙体;修复体外形稍突或稍凹;或有咬合但恢复不足;或边缘嵴恢复稍不足;或唇侧外形扁平;或舌侧外形扁平
不可接受 修复体外形明显过突或过凹;或咬合受影响;或接触点恢复不好;或有边缘悬突;或有创伤牙合;或整体咬合恢受不足;或造成无法缓解的牙齿或邻近组织疼痛;或造成牙齿、软组织或支持骨的破坏
表面 修复体表面平滑,对周围组织无刺激
可接受 修复体稍粗糙但可抛光
不可接受 表面很不规则不能抛光改善且与解剖外形无关;或表面折裂;或冠材料整体疏松多孔
颜色 修复体明暗度和/或透明度与邻牙协调
可接受 修复体明暗度与邻牙轻微不协调
不可接受 修复体与邻牙不协调,色度、明暗度或透明度超出正常范围,或明暗度与邻牙很不协调
牙龈健康状况 牙龈健康
可接受 有轻微牙龈炎症,探针有少量出血及轻度龈萎缩,但不影响美观
不可接受 戴入后有明显牙龈红肿、出血、牙周袋加深及影响美观的牙龈萎缩
表2 纤维桩瓷全冠修复体的临床评价结果[例(%),n=64]
表3 不同余留牙体量时纤维桩瓷全冠修复效果
图1 修复前:11、21 根管治疗后
图2 11、21 纤维桩修复
图3 11、21 e.max 全瓷冠修复,12 树脂修复后
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