单炜 阮文华

[摘要] 婴幼儿乳牙残根残冠的修复因其较差的临床疗效一直以来都是儿童口腔治疗的难点。临床常用的恒牙根管桩核系统因其不可吸收性，影响乳恒牙的更替，无法满足乳牙残根残冠修复的性能要求。近年来，随着聚乳酸在医学领域的广泛的应用，聚乳酸根管桩良好的生物学特性为实现与乳牙牙根同步吸收的修复方法提供了新的思路。本文就聚乳酸可吸收根管桩桩核系统的研究现状作一综述。

[关键词] 聚乳酸根管桩；聚乳酸可吸收薄膜；可吸收粘接系统

[中图分类号] R783 [文献标识码] A [文章编号] 1674-0742（2018）05（a）-0196-03

Research Progress on Polylactic Acid Absorbable Root Canal Pile Core System

SHAN Wei， RUAN Wen-hua

Department of Stomatology， Children's Hospital Affiliated to the Medical School of Zhejiang University， Hangzhou， Zhejiang Province， 310051 China

[Abstract] Because of poor clinical efficacy， reparative therapy for residual crown and root resulting from early childhood caries has been a difficult issue in odontopathy treatment of children for a long time. The usual permanent tooth post and core system affects the alternation of deciduous and permanent tooth because of non-absorbable character， which cannot meet the requirements of performance of repairing residual crown and root of deciduous tooth. In recent years， along with the application of the polylactic acid （PLA） in the medical field， good biological characteristics of the PLA post has provided new thinking to the realization of repair method which is absorbed with root simultaneously. This article presents a review of the research progress on the polylactic acid absorbable root canal pile core system in recent years.

[Key words] Polylactic acid post； PLA absorbable membrane； Absorbable bonding system

严重婴幼儿龋（severe early childhood caries， S-ECC）造成的乳牙残根残冠在临床上较为常见，因剩余健康牙体组织抗力形及固位形较差，其常规修复后修复体较易脱落，最终只得采取对症治疗或者拔除。这种治疗方式不仅影响婴幼儿的面部美观、发音，还会影响继承恒牙的萌出和颌骨的生长发育，甚至诱发错颌畸形[1]。因此，乳牙残根残冠的修复保留，对于恢复患儿部分咀嚼功能，维持乳牙在牙列中的位置，保证乳恒牙的正常替换，颌面部的发育起着至关重要的作用。临床上常用于恒牙修复的玻璃纤维桩和金属螺纹桩，因其不能与乳牙牙根同步吸收而影响正常乳恒牙的替换，从而不能用于乳牙残根残冠的修复。近年来，随着生物可吸收材料广泛应用于临床，聚乳酸可吸收根管桩因其良好的生物相容性、生物力学性能以及可降解性为实现能与乳牙牙根同步吸收的修复方法提供了思路[2]。……